A comparison of fibrinogen measurement methods with fibrin clot elasticity assessed by thromboelastometry, before and after administration of fibrinogen concentrate in cardiac surgery patients

Solomon, Cristina; Cadamuro, Janne; Ziegler, Bernhard; Schöchl, Herbert; Varvenne, M.; Sørensen, Benny; Hochleitner, Gerald; Rahe‐Meyer, Niels

doi:10.1111/j.1537-2995.2011.03066.x

Cited by 96 publications

(75 citation statements)

References 48 publications

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“…Firmness of the fibrin-based clot is measured in SI units (Système International d'Unités) that are completely different from those of fibrinogen concentration (dyne/cm 2 or gigapascal, PERIOPERATIVE MEDICINE as opposed to g/l or mol/l). 32 Nevertheless, studies have shown correlation between FIBTEM MCF and measurements of fibrinogen concentration. 13,22 The aim was to restore FIBTEM MCF to 22 mm, higher than the mean preoperative baseline level of 16-18 mm and at the high end of the normal range (9-25 mm).…”

Section: Fibrinogen Concentrate Therapy In Aortic Surgerymentioning

confidence: 99%

Effects of Fibrinogen Concentrate as First-line Therapy during Major Aortic Replacement Surgery

et al. 2013

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Background: Fibrinogen is suggested to play an important role in managing major bleeding. However, clinical evidence regarding the effect of fibrinogen concentrate (derived from human plasma) on transfusion is limited. The authors assessed whether fibrinogen concentrate can reduce blood transfusion when given as intraoperative, targeted, first-line hemostatic therapy in bleeding patients undergoing aortic replacement surgery. Methods: In this single-center, prospective, placebocontrolled, double-blind study, patients aged 18 yr or older undergoing elective thoracic or thoracoabdominal aortic replacement surgery involving cardiopulmonary bypass were randomized to fibrinogen concentrate or placebo, administered intraoperatively. Study medication was given if patients had clinically relevant coagulopathic bleeding immediately after removal from cardiopulmonary bypass and completion of surgical hemostasis. Dosing was individualized using the fibrin-based thromboelastometry test. If bleeding continued, a standardized transfusion protocol was followed. Results: Twenty-nine patients in the fibrinogen concentrate group and 32 patients in the placebo group were eligible for the efficacy analysis. During the first 24 h after the administration of study medication, patients in the fibrinogen concentrate group received fewer allogeneic blood components than did patients in the placebo group (median, 2 vs. 13 U; P < 0.001; primary endpoint). Total avoidance of transfusion was achieved in 13 (45%) of 29 patients in the fibrinogen concentrate group, whereas 32 (100%) of 32 patients in the placebo group received transfusion (P < 0.001). There was no observed safety concern with using fibrinogen concentrate during aortic surgery.

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Section: Fibrinogen Concentrate Therapy In Aortic Surgerymentioning

confidence: 99%

Effects of Fibrinogen Concentrate as First-line Therapy during Major Aortic Replacement Surgery

et al. 2013

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“…The maximum clot fi rmness, or maximum amplitude, is measured after a defi ned time. The results are not only dependent on the fi brinogen concentration, but may be infl uenced by hematocrit, FXIII, heparin, hydroxyl-ethyl starch, gelatin, and albumin (Solomon et al 2011 ;Ogawa et al 2012 ;Schlimp et al 2013 ). None of these tests is standardized, and the international, gold standard test is currently debated.…”

Section: Monitoringmentioning

confidence: 96%

Coagulation Factor Concentrates

Asmis¹

2014

Perioperative Hemostasis

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“…Neither test is a suitable substitute for the traditional plasma-based determination of fi brinogen levels using the Clauss method. Furthermore, the correlation between FIBTEM MCF and the plasmatic concentration of fi brinogen worsens after exogenous fi brinogen administration (Solomon et al 2011 ).…”

Section: 6mentioning

confidence: 99%