Guidelines on fibrinogen assays

Cryoprecipitate transfusion: assessing appropriateness and dosing in trauma

“…Total clottable protein assays have high accuracy and are used as reference method for plasma fibrinogen measurement (Mackie et al, 2003). However, these assays are technically difficult and time-consuming to perform; thus rarely required in clinical practice (Lowe et al, 2004 Traditionally, plasma fibrinogen assays have been performed for the investigation, monitoring and management of hemorrhagic risks associated with low congenital or acquired fibrinogen levels.…”

“…The use of mechanical end-point technology is based on the tensile strength of the clot in a magnetic field. Despite being sensitive at low fibrinogen concentrations, this technique is specially affected by heparin therapy, which can be overcome with in vitro heparin neutralization and re-running of the sample (Mackie et al, 2003). Photooptical systems are also used and measure the changes in light scatter through 90˚ or light transmission as a result of fibrin formation.…”

“…There are currently several laboratory methods available for the measurement of plasma In general, clotting rate assays, which use clotting time of plasma dilutions for the determination of functional plasma fibrinogen levels, remain the routine assay of choice for the diagnosis of hypofibrinogenemia in the context of bleeding (Mackie et al, 2003). Total clottable protein assays have high accuracy and are used as reference method for plasma fibrinogen measurement (Mackie et al, 2003).…”

Quantitative reagent-free detection of fibrinogen levels in human blood plasma using Raman spectroscopy

“…1 Epidemiological studies have demonstrated elevated levels of fibrinogen in blood to be an independent risk factor for cardiovascular and coronary heart disease 2, 3 , while low fibrinogen levels are seen as an important diagnostic physiological variable in pathological conditions 40 including various haemorrhagic states, disseminated intravascular coagulation, liver disease and during thrombolytic/defibrination therapy. 4 Fibrinogen concentration has also been shown to be an independent prognostic parameter in patients diagnosed with cervical cancer. 5 45 Fibrinogen levels in plasma may be determined through various methods.…”

“…The Clauss assay is relatively time consuming with respect to calibration, requiring sufficient expertise to evaluate difficult end points from high dilutions of standard plasmas, samples with low fibrinogen content or those forming unstable clots. 4 Analysers 80 ARTICLE TYPE www.rsc.org/xxxxxx | XXXXXXXX relying on mechanical, tensile clot strength end point detection may be affected by heparin therapy while photo optical systems measuring light scattering changes may be vulnerable to slow fibrin polymerisation, turbid reference plasma samples along with the presence of any bile pigment or free haemoglobin. 4, 13 5 Inconsistencies arise when fibrinogen levels are measured using commercial reagents sourced from different manufacturers.…”