Fibrinogen replacement in trauma haemorrhage

Nicola Curry,Simon Stanworth,Ross Davenport,Claire Rourke,Karim Brohi

doi:10.1186/1757-7241-22-s1-a5

Abstract

Fibrinogen replacement in trauma haemorrhage

Highlights

There is a growing interest in the role that fibrinogen plays in major haemorrhage
The effects of fibrinolysis are likely exacerbated in trauma haemorrhage by low fibrinogen levels, since fibrin strands formed in a hypofibrinogenaemic environment are more susceptible to lysis
Curry et al Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2014, 22(Suppl 1):A5 http://www.sjtrem.com/content/22/S1/A5. For those patients with coagulopathy, ex vivo addition of therapeutic concentrations of fibrinogen (in the form of cryoprecipitate or fibrinogen concentrate (FgC)), led to ‘reversal’ of acute traumatic coagulopathy as defined by ROTEM measurements, providing early evidence that fibrinogen supplementation may be of clinical benefit in trauma haemorrhage

Summary

Introduction

There is a growing interest in the role that fibrinogen plays in major haemorrhage. It has been known since 1995 that fibrinogen is one of the first coagulation proteins to fall to critically low levels during major blood loss [1], but the clinical relevance of this is only being evaluated. A large UK epidemiological study of patients with traumatic haemorrhage reported the annual cost to the NHS of treating major haemorrhage was £168 million (2012 prices) (NIHR PGfAR: ‘Traumatic Coagulopathy & Massive Transfusion: Improving Outcomes & Saving Blood, 2013).

Results

Conclusion