2020
DOI: 10.1111/1742-6723.13484
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Abstract: Objective Haemorrhage in paediatric trauma remains a significant cause of morbidity and mortality. Over recent years there has been increasing attention to the role of fibrinogen in traumatic haemorrhage and the association of low fibrinogen levels with poor patient outcomes. In addition, there has been a move towards using viscoelastic haemostatic assays (VHAs) to rapidly assess coagulation status and guide clinicians in the replacement of coagulation factors, including fibrinogen. In the paediatric populatio… Show more

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Cited by 5 publications
(7 citation statements)
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“…The high incidence of hypofibrinogenemia in this relatively small cohort might suggest that there is a high rate of undetected hypofibrinogenemia in this population and validation in a sequential prospective cohort is warranted. The early treatment of hypofibrinogenemia in multi‐region trauma is increasingly recognised to reduce the requirement for massive transfusion and reduce mortality in adults; however, there are limited data in children 3,19,20 . Future studies focused on patient‐centred functional outcomes are required to better inform clinical practice.…”
Section: Discussionmentioning
confidence: 99%
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“…The high incidence of hypofibrinogenemia in this relatively small cohort might suggest that there is a high rate of undetected hypofibrinogenemia in this population and validation in a sequential prospective cohort is warranted. The early treatment of hypofibrinogenemia in multi‐region trauma is increasingly recognised to reduce the requirement for massive transfusion and reduce mortality in adults; however, there are limited data in children 3,19,20 . Future studies focused on patient‐centred functional outcomes are required to better inform clinical practice.…”
Section: Discussionmentioning
confidence: 99%
“…2 Major haemorrhage protocols (MHP) remain an important part of haemorrhage management, but they have been slower to appear in the paediatric literature. 3 While their use within the paediatric population is increasing, they are frequently based upon the adult evidence. Strategies include ratio-based transfusion, with ratios approaching 1:1:1 of packed red blood cells, fresh frozen plasma (FFP) and platelets; viscoelastic haemostatic assay (VHA) guided MHP or a hybrid MHP using both VHA and fixed ratio transfusion.…”
Section: Introductionmentioning
confidence: 99%
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“…The role of viscoelastic haemostatic assays in paediatric trauma resuscitation is evolving. Targeted blood product replacement based on rotational thromboelastometry or thromboelastography is a potential alternative to fixed ratio blood product replacement, though at this stage there is limited data to support a more targeted approach to blood product replacement 31 …”
Section: Discussionmentioning
confidence: 99%