Breathing in medicine may stop lung bleeding faster than IV

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Age ≥18 years. * Presenting with active hemoptysis 24-48 hours prior to enrollment, or ongoing bleeding at presentation. * Patients presented with mild to moderate hemoptysis, defined as \<100 mL/day, or with clinically stable non-massive hemoptysis without evidence of respiratory or hemodynamic compromise. * Hemodynamically stable at presentation defined as systolic blood pressure ≥90 mmHg without vasopressor support, heart rate ≤120 beats/min, and absence of clinical signs of shock or ongoing hemodynamic deterioration. * Patients able to maintain a patent airway, tolerate nebulized therapy, and have no immediate contraindications (e.g., severe bronchospasm, impaired consciousness with aspiration risk, or need for urgent intubation), ensuring safe and effective drug delivery. * Written informed consent obtained from the patient. Exclusion Criteria: * Massive or life-threatening hemoptysis defined as expectoration of \>100 mL of blood within 24 hours, or any volume associated with impaired gas exchange, airway obstruction, or hemodynamic instability requiring urgent intervention (e.g., bronchoscopy, bronchial artery embolization, endotracheal intubation, or surgery). * Hemodynamic instability which defined as SBP \<90 mmHg or MAP \<65 mmHg, need for vasopressor support, or clinical evidence of end-organ hypoperfusion or shock. * Respiratory failure requiring immediate invasive mechanical ventilation. * Patients known with hypersensitivity to tranexamic acid. * Patients receiving ongoing anticoagulant therapy that can interfere with the antifibrinolytic effect of tranexamic acid. * Patients with known bleeding disorders, severe coagulopathy, or thrombocytopenia (platelet count \<50,000/mm³). * Patients with severe renal impairment (e.g., estimated glomerular filtration rate \<30 mL/min/1.73 m² or requiring dialysis). * Patients with active thromboembolic disease or a recent history (within the past 3-6 months) of deep vein thrombosis, pulmonary embolism, ischemic stroke, or myocardial infarction. * Pregnancy or lactation.