The decrease of fibrinogen is an early predictor of the severity of postpartum hemorrhage

Charbit, Bény; Mandelbrot, Laurent; Samain, Emmanuel; Baron, Gabriel; Haddaoui, B.; Keïta, H.; Sibony, Olivier; Michelet, Dominique; Hurtaud‐Roux, Marie‐Françoise; Huisse, Marie-Geneviève; Denninger, Marie‐Hélène; Prost, Dominique de

doi:10.1111/j.1538-7836.2007.02297.x

Cited by 636 publications

(526 citation statements)

References 25 publications

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“…The median clot amplitude values at various time points were significantly lower in the haemorrhage group than in controls. This included measurements taken at the very early time point: CA 5 . The lower clot amplitudes in cases of PPH, associated with lower fibrinogen values, translated into substantial differences observed in real time on FIBTEM TEMograms (Figure 2).…”

Section: Results Of Laboratory Haemostasis Tests and Delocalised Rotemmentioning

confidence: 99%

“…We determined cut-off values of CA 5 and CA 15 for different concentrations of fibrinogen level PPH (Table 3). …”

Section: Correlation Between Fibtem and Fibrinogen Levelsmentioning

confidence: 99%

“…Sensitivity, specificity and negative/predictive values were determined for several fibrinogen levels in both groups. Cut-off values for CA 5 and CA 15 were chosen to optimise the negative predictive value in patients with fibrinogen levels below 2 g/l. A two-tailed P-value £0.05 was considered significant.…”

Section: Statistical Considerationsmentioning

confidence: 99%

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Bedside assessment of fibrinogen level in postpartum haemorrhage by thrombelastometry

Huissoud

Carrabin

Audibert

et al. 2009

BJOG

206

161

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Objectives To establish whether reagent-supported thrombelastometry with the rotation thrombelastometry system (ROTEM Ò ) point-of-care device correlated with fibrinogen level in postpartum haemorrhages.Design Prospective observational study.Population and setting Ninety-one women at the third trimester of pregnancy: 37 with postpartum haemorrhage (study group) and 54 without abnormal bleeding (control group).Methods Standard laboratory test results were compared with those obtained at bedside from the ROTEM with the FIBTEM Ò test (54 tests in the control group and 51 in the study group). Results Median fibrinogen level was significantly lower in the haemorrhage group than in the control group (3.4 and 5.1 g/l, respectively, P < 0.0001). Median CT was higher in the haemorrhage group than in the control group (P = 0.05). CA 5 , CA 15 and MCF were significantly lower in the haemorrhage group than in controls (P < 0.0001) and strongly correlated with fibrinogen levels in both groups (r = 0.84-0.87, P < 0.0001). A cut-off value of CA 5 at 5 mm and CA 15 at 6 mm presented an excellent sensitivity (100% for both parameters) and a good specificity (respectively 85 and 88%) to detect fibrinogen levels <1.5 g/l in postpartum haemorrhage.Conclusions The early parameters obtained from the FIBTEM test correlated well with fibrinogen levels. ROTEM might be helpful in guiding fibrinogen transfusion during postpartum haemorrhage.

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Section: Results Of Laboratory Haemostasis Tests and Delocalised Rotemmentioning

confidence: 99%

“…We determined cut-off values of CA 5 and CA 15 for different concentrations of fibrinogen level PPH (Table 3). …”

Section: Correlation Between Fibtem and Fibrinogen Levelsmentioning

confidence: 99%

See 1 more Smart Citation

Bedside assessment of fibrinogen level in postpartum haemorrhage by thrombelastometry

Huissoud

Carrabin

Audibert

et al. 2009

BJOG

206

161

View full text Add to dashboard Cite

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“…This test is affected by heparin and fibrinogen degradation products. Excessive bleeding has been reported at fibrinogen levels below 50-100 mg dl -1 [8,18,19], but there recent evidence indicates that higher levels of fibrinogen are required for sufficient fibrin clot polymerization, with target levels at 200-380 mg dl -1 [20,21].…”

Section: Fibrinogen Concentrationmentioning

confidence: 99%

Perioperative coagulopathy monitoring

et al. 2013

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Coagulopathy is common in orthopedic surgery patients either due to acquired factors, such as surgery, trauma, medications, or hemorrhage. Perioperative monitoring of blood coagulation is critical to diagnose the causes of hemorrhage, guide hemostatic therapies, predict the risk of bleeding during surgical procedures, and reduce risk of postoperative cardiac and thromboembolic events. In contrast to previous interventions that measure specific portions of the clotting cascade (such as intrinsic or extrinsic pathways or platelet aggregation), ''Point-ofcare'' coagulation monitoring devices assess the viscoelastic properties of whole blood. These techniques have the potential to measure the entire clotting process, starting with fibrin formation, clot retraction, and fibrinolysis. Furthermore, the coagulation status of patients is assessed in whole blood, allowing the plasmatic coagulation system to interact with platelets and red cells, and thereby providing useful additional information on platelet function. Improved monitoring of coagulopathy is particularly important as new anticoagulant drugs emerge that affect the clotting cascade in novel ways, including the inhibition of intrinsic and extrinsic pathways and platelet function. It is important for orthopedic surgeons to understand the pharmacology and reversal of these drugs in the perioperative setting. The purpose of this review is to review the current techniques to monitoring perioperative coagulopathy and to identify the manner in which novel anticoagulant medications affect the clotting cascade with particular interest in trauma and spine surgery.

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“…Fibrinogen supplementation should be given when the value of fibrinogen is under 1 g/L, but some research proves that the value of fibrinogen under 2 g/L will give bad impact for the patients. [16][17][18] The most current scoring for trauma is using Injury Severity Score (ISS). ISS is a complex scoring system that summarizes patients data into one of numerical data.…”

Section: Introductionmentioning

confidence: 99%

Relationship between initial fibrinogen level with coagulopathy and mortality in multiple trauma patients

2017

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Background: In trauma induced coagulopathy (TIC), low fibrinogen value is often found and plasma fibrinogen reached low value earlier than other parameters of coagulation factors. Initial fibrinogen value is strongly correlated to the injury severity score (ISS) and be an independent predictor of mortality. This study was expected to see the relationship between initial fibrinogen level with coagulopathy and mortality, so it can predict early coagulopathy and can prevent bleeding complications that lead to mortality. Methods: The study was conducted prospectively. The entire examination obtained from patients with multiple trauma. Fibrinogen levels and coagulopathy were taken from the blood laboratory tests in conjunction with other routine examination when patients were admitted to the ER of Hasan Sadikin General Hospital. Outcome parameters were the incidence of coagulopathy and mortality. Statistical analyses were performed to look at the significance of relationships.Results: Of the 25 patients with multiple trauma obtained a majority of 80% were male patients and with the highest incidence mechanism was head trauma as many as 16 people (64%). There were 8 patients (32%) experienced coagulopathy and mortality occurred in 7 patients (28%). Chi square analysis found a significant association between fibrinogen and coagulopathy (p = 0.043), while the association between initial fibrinogen with mortality was not significant (p = 0.341).Conclusions: Initial fibrinogen level is significantly associated with coagulopathy but it cannot predict mortality in patients with multiple trauma. Further study is needed in order to assess the benefit of these results on the management of multiple trauma patients.

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The decrease of fibrinogen is an early predictor of the severity of postpartum hemorrhage

Cited by 636 publications

References 25 publications

Bedside assessment of fibrinogen level in postpartum haemorrhage by thrombelastometry

Bedside assessment of fibrinogen level in postpartum haemorrhage by thrombelastometry

Perioperative coagulopathy monitoring

Relationship between initial fibrinogen level with coagulopathy and mortality in multiple trauma patients

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