Impact of Fibrinogen Levels on Outcomes after Acute Injury in Patients Requiring a Massive Transfusion

Inaba, Kenji; Karamanos, Efstathios; Lustenberger, Thomas; Schöchl, Herbert; Shulman, Ira A.; Nelson, Janice M.; Rhee, Peter; Talving, Peep; Lam, Lydia; Δημητριάδης, Δημήτριος

doi:10.1016/j.jamcollsurg.2012.10.017

Cited by 144 publications

(103 citation statements)

References 45 publications

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“…In cases of severe trauma, depleted plasma fibrinogen levels are frequently observed before dilution by infusion [5][6][7][8][9]. Furthermore, plasma fibrinogen levels deteriorate more frequently and earlier than other routine coagulation parameters (prothrombin time, activated partial thromboplastin time, and platelet count) in severe trauma patients [5].…”

Section: Fibrinogen Level In Acute Phases Of Traumamentioning

confidence: 99%

“…Critical (≤1.0 g/L) and abnormal (1.0-1.8 g/L) fibrinogen levels were also reported in 21 and 44% of severe trauma patients who required massive transfusions, respectively [8]. Decreased plasma fibrinogen levels on arrival at the emergency department are an independent predictor of massive transfusion requirement and death in severe trauma patients [5][6][7][8][9].…”

Section: Fibrinogen Level In Acute Phases Of Traumamentioning

confidence: 99%

“…Severe trauma-related depletion of plasma fibrinogen levels is observed before and upon emergency department admission, and levels continue to decrease after blood infusion/transfusion therapy initiation [5][6][7][8][9]. We showed that plasma fibrinogen levels deteriorate earlier and more frequently than other routine coagulation parameters (prothrombin time, activated partial thromboplastin time, and platelet count) in severe trauma patients after the initiation of infusion/transfusion therapies [5].…”

Section: Dilution By Infusion/transfusion Therapymentioning

confidence: 99%

See 2 more Smart Citations

Dynamics of fibrinogen in acute phases of trauma

Hayakawa

2017

j intensive care

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Fibrinogen is a unique precursor of fibrin and cannot be compensated for by other coagulation factors. If plasma fibrinogen concentrations are insufficient, hemostatic clots cannot be formed with the appropriate firmness. In severe trauma patients, plasma fibrinogen concentrations decrease earlier and more frequently than other coagulation factors, predicting massive bleeding and death. We review the mechanisms of plasma fibrinogen concentration decrease, which include coagulation activation-induced consumption, hyper-fibrino(geno)lysis-induced degradation, and dilution by infusion/transfusion. Understanding the mechanisms of plasma fibrinogen concentration decrease in severe trauma patients is crucial.

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Section: Fibrinogen Level In Acute Phases Of Traumamentioning

confidence: 99%

Section: Fibrinogen Level In Acute Phases Of Traumamentioning

confidence: 99%

Section: Dilution By Infusion/transfusion Therapymentioning

confidence: 99%

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Dynamics of fibrinogen in acute phases of trauma

Hayakawa

2017

j intensive care

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“…Hyperfibrinolysis in the setting of severe trauma is a central component of TIC and although relatively rare is associated with poor outcomes (34) (35) (36). The association between hypofibrinogenaemia and worse outcomes in severe trauma has been well demonstrated although to date the pathophysiological mechanisms remain incompletely understood (22) (37) (38).…”

mentioning

confidence: 99%

Fibrinogen in traumatic haemorrhage: A narrative review

Winearls

Campbell

Hurn

et al. 2017

Injury

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Abstract:Haemorrhage in the setting of severe trauma is associated with significant morbidity and mortality. There is increasing awareness of the important role fibrinogen plays in traumatic haemorrhage. Fibrinogen levels fall precipitously in severe trauma and the resultant hypofibrinogenaemia is associated with poor outcomes. Hence, it has been postulated that early fibrinogen replacement in severe traumatic haemorrhage may improve outcomes, although, to date there is a paucity of high quality evidence to support this hypothesis. In addition there is controversy regarding the optimal method for fibrinogen supplementation. We review the current evidence regarding the role of fibrinogen in trauma, the rationale behind fibrinogen supplementation and discuss current research.

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“…Hypofibrinogenemia is well documented in clinical and experimental studies of ATC, and has been correlated with both early and late mortality (100)(101)(102)(103). Early fibrinogen replacement has been shown to improve outcomes and correct coagulopathy (87,100,104,105).…”

Section: The Importance Of Fibrinogen and Fibrinolysismentioning

confidence: 99%

Validation of acute traumatic coagulopathy in an ovine model of trauma and haemorrhage

Zyl¹

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This thesis describes an ovine model of complex trauma and haemorrhage that demonstrates coagulation changes using both traditional plasma based assays and point of care viscoelastic assays that are consistent with current definitions of ATC. The degree of coagulopathy was correlated with the degree of shock as quantified by arterial lactate.Coagulopathy was also associated with activation of the protein C pathway and shedding of the endothelial glycocalyx. Fibrinolysis did not make a significant contribution to the coagulopathy observed and there was no evidence of altered platelet function in this model.ii

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Impact of Fibrinogen Levels on Outcomes after Acute Injury in Patients Requiring a Massive Transfusion

Cited by 144 publications

References 45 publications

Dynamics of fibrinogen in acute phases of trauma

Dynamics of fibrinogen in acute phases of trauma

Fibrinogen in traumatic haemorrhage: A narrative review

Validation of acute traumatic coagulopathy in an ovine model of trauma and haemorrhage

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