The authors performed a pilot study comparing topical versus intravenous administration of tranexamic acid. Given the heterogeneity of cardiac surgery patients, the lack of any difference in outcome between the two groups, in terms of chest tube drainage and transfusion requirement, does not infer any change in clinical practice.

The authors underline that observations should be evaluated in a properly sized randomised controlled trial. Given the fact that the main purpose was to avoid side effects with topical administration, the study would have benefitted from measurement of tranexamic acid blood levels in both groups.

– Hanne Berg Ravn

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