Evaluation of fibrinogen concentrates and prothrombin complex concentrates on coagulation changes in a hypothermic in vitro model using thromboelastometry and thromboelastography

Abstract

Coagulopathy caused by the 30°C hypothermia in vitro model can be corrected by fibrinogen concentrate compared to prothrombin complex concentrate. In spite of a tendency to prothrombotic status, this was not significant with the use of the recommended dose of fibrinogen even after warming the blood to 37°C. However, measurement performed at 37°C seems to be safer than at 30°C.

Massive hemorrhage management – a best evidence topic report

“… 43 Hypothermic coagulopathy is very challenging to treat in bleeding patients, but it was shown that coagulopathy caused by hypothermia can be reversed and successfully corrected by fibrinogen concentrate. 44 However, the prothrombin complex is not able to correct hypothermic coagulopathy. 44 …”

Adaptation of global hemostasis to therapeutic hypothermia in patients with out-of-hospital cardiac arrest: Thromboelastography study

“…Some studies suggest that hypothermia may modify the coagulation cascade due to regulation of coagulation factor activities; most of which are thermo-sensitive [16,17]. In practice, this anticoagulation effect may have an additional cardioprotective action, especially for CA patients who usually have an imbalanced coagulation cascade toward thrombosis [1,2,18].…”

Direct thrombolysis of multiple thrombi in both right and left heart atrium in a patient on extracorporeal membrane oxygenation support following urgent double-lung transplantation: a case report

“… 14 ECMO carries a high risk for both bleeding and thrombotic complications. 6 , 7 Massive thrombosis in the early postoperative period can be a severe complication in transplant surgery. 8 Catheter-related atrial thrombosis is a potentially deadly complication of intravascular devices.…”

“… 6 Due to the high risk in all patients with the ECMO support, including the lung transplant patients for both bleeding and thrombotic complications, which can reach 5%, experts in hemostasis can significantly affect the care of patients requiring mechanical circulatory support, and are a necessary part of the management team. 6 , 7 Massive thrombosis in the early postoperative period can be a severe complication in transplant surgery. 8 Catheter-related atrial thrombosis is a potentially deadly complication of intravascular devices.…”