The Effects of Fibrinogen Levels on Thromboelastometric Variables in the Presence of Thrombocytopenia

Lang, Thomas; Johanning, Kai; Metzler, H.; Piepenbrock, S.; Solomon, Cristina; Rahe‐Meyer, Niels; Tanaka, Kenichi A.

doi:10.1213/ane.0b013e3181966675

Cited by 262 publications

(238 citation statements)

References 36 publications

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“…Significant correlation among MA, fibrinogen concentration, and platelet count has been reported in both normal and hypercoagulable people and dogs 27, 28, 29. Fibrinogen has been reported to increase MA in both humans and dogs because of the fact that MA is primarily dependent on the cross binding of platelets and fibrinogen 30, 31. Fibrinogen may be considered one of the “driving forces” behind inflammation because it directly influences the production of proinflammatory cytokines and chemokines,10, 32, 33 and this is further supported in this study by the positive correlations among MA, total leukocyte count and mature neutrophil count—cells responsible for the production of cytokines and chemokines.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Hemostatic Abnormalities in Canine Spirocercosis and Its Association with Systemic Inflammation

Pazzi

Goddard

Kristensen

et al. 2013

Veterinary Internal Medicne

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BackgroundCanine spirocercosis is caused by the nematode Spirocerca lupi and is characterized by esophageal fibro‐inflammatory nodules that may undergo neoplastic transformation. No sensitive and specific laboratory assays other than histopathology have been reported to differentiate non‐neoplastic from neoplastic disease.Hypothesis/ObjectivesDogs with spirocercosis will have evidence of hypercoagulability based on thromboelastography (TEG)‐derived maximal amplitude (MA); increased MA will be correlated with increased acute phase protein (APP) concentrations (C‐reactive protein [CRP] and fibrinogen); increased MA and APPs will be exacerbated with neoplastic spirocercosis.AnimalsThirty‐nine client‐owned dogs with naturally occurring spirocercosis and 15 sex‐matched healthy controls.MethodsA prospective comparative study evaluating TEG, activated partial thromboplastin time, prothrombin time, antithrombin (AT) activity, platelet count and D‐dimer concentration, and APPs of dogs with non‐neoplastic (n = 24) and neoplastic (n = 15) spirocercosis compared to control dogs.ResultsMedian MA was significantly increased in the non‐neoplastic group (P < .01) and neoplastic group (P < .01) compared to the controls. Both APPs were significantly increased in the neoplastic group compared to the non‐neoplastic and control groups. MA was strongly correlated with fibrinogen (r = 0.85, P < .001) and CRP (r = 0.73, P < .001). An MA >76 mm provided 96% specificity and 73% sensitivity for differentiation of disease state.Conclusions and Clinical ImportanceCanine spirocercosis is associated with increased TEG variables, MA and α, and decreased AT activity, which may indicate a hypercoagulable state seemingly more severe with neoplastic transformation. MA was correlated with APP in dogs with spirocercosis and can be used as an adjunctive test to support the suspicion of neoplastic transformation.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Hemostatic Abnormalities in Canine Spirocercosis and Its Association with Systemic Inflammation

Pazzi

Goddard

Kristensen

et al. 2013

Veterinary Internal Medicne

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“…Although knowledge of plasma fibrinogen levels is required for prompt treatment of patients with severe trauma, the laboratory measurements of fibrinogen levels usually takes more than 30 min. Therefore, the early evaluation of fibrinogen levels is considered important [4,7,48,50,51,53,66]. Thromboelastometry has been widely used for early evaluation of fibrinogen level in severe trauma patients [4,7,48,50,51,53].…”

Section: Evaluation and Treatment For Fibrinogen Consumption And Hypementioning

confidence: 99%

“…Furthermore, fibrinogen also acts as the ligand for glycoprotein IIb/IIIa receptors, found on the platelet surface, thereby accelerating platelet aggregation, similar to the role of the von Willebrand factor [2,3]. In cases of thrombocytopenia, clot strength increases in direct proportion to plasma fibrinogen concentration, independent of platelet count [4]. Therefore, in acute phases of severe trauma, where bleeding control is important, fibrinogen plays a central role in hemostasis.…”

Section: Introductionmentioning

confidence: 99%

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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“…Fibrinogen is synthesized in the liver by the hepatocytes [9]. Research from 2011 has shown that fibrin plays a key role in the inflammatory response and development of rheumatoid arthritis [10]. Fibrinogen levels can be measured in venous blood.…”

Section: Introductionmentioning

confidence: 99%

Association of Fibrinogen, Erythrocyte Sedimentation Rate and C-Reactive Protein Levels with Rheumatoid Arthritis

Babikir¹,

Gaufri²

2017

OALib

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Background: Many studies were made the association between the extent of the inflammatory response, increase fibrinogen level and hypercoagulability in rheumatoid arthritis. The current study aims to the investigation and finds the association of the fibrinogen, ESR and CRP levels in Sudanese patients with rheumatoid arthritis. Material and Methods: This is a case-control study, conducted at Modern Medical Center, Khartoum, Sudan, during January 2016. Totally 100 participants were chosen for this study, among them 50 were known Sudanese patients professionally diagnosed with rheumatoid arthritis as case group, and the other 50 participants were normal healthy subjects as control group; their age and gender coordinated with case group. 3 ml of blood was collected in Tri Sodium citrate container, and other 3 ml in plain container. Platelet poor plasma prepared by centrifugation of tri sodium citrate container, and then plasma separated to estimate fibrinogen. Serum was prepared form clotted blood to measure CRP. The ESR was done by Westergren tube from citrated blood in one hour .The data were collected by structured interview and questionnaire, and then analyzed by using a computer program statistical package for social sciences (SPSS) version 20. Results: Significant elevated of the plasma fibrinogen, CRP levels and ESR were observed in subjects with rheumatoid arthritis in comparison with that normal control group with (p value 0.000). Conclusion: This study has shown that rheumatoid arthritis lead to increase level of fibrinogen, ESR and CRP. This abnormality could be contributed to the hypercoagulability phenomenon.

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The Effects of Fibrinogen Levels on Thromboelastometric Variables in the Presence of Thrombocytopenia

Cited by 262 publications

References 36 publications

Evaluation of Hemostatic Abnormalities in Canine Spirocercosis and Its Association with Systemic Inflammation

Evaluation of Hemostatic Abnormalities in Canine Spirocercosis and Its Association with Systemic Inflammation

Dynamics of fibrinogen in acute phases of trauma

Association of Fibrinogen, Erythrocyte Sedimentation Rate and C-Reactive Protein Levels with Rheumatoid Arthritis

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