Time Course of Haemostatic Effects of Fibrinogen Concentrate Administration in Aortic Surgery

Solomon, Cristina; Hagl, Christian; Rahe‐Meyer, Niels

doi:10.1097/01.sa.0000443069.02547.6f

Cited by 12 publications

(20 citation statements)

References 9 publications

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“…We did not find any adverse events associated with fibrinogen concentrate, in line with other studies [36]. Volume overload with FFP is a significant clinical problem [16], even in relatively young fit patients.…”

supporting

confidence: 78%

Introduction of an algorithm for ROTEM-guided fibrinogen concentrate administration in major obstetric haemorrhage

et al. 2014

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SummaryWe compared blood component requirements during major obstetric haemorrhage, following the introduction of fibrinogen concentrate. A prospective study of transfusion requirements and patient outcomes was performed for 12 months to evaluate the major obstetric haemorrhage pathway using shock packs (Shock Pack phase). The study was repeated after the pathway was amended to include fibrinogen concentrate (Fibrinogen phase).

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supporting

confidence: 78%

Introduction of an algorithm for ROTEM-guided fibrinogen concentrate administration in major obstetric haemorrhage

et al. 2014

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“…Therefore, fibrinogen concentrate is available for almost immediate use, and relatively large doses can be administered in a few minutes. The packet insert states that reconstitution in water should be completed in 5 to 10 minutes (and within a maximum of 15 min), and although the manufacturer recommends an infusion rate of no more than 5 mL/min, it is possible to infuse 1 g in less than 20 seconds in cases of severe bleeding …”

Section: Fibrinogen Concentratementioning

confidence: 99%

Fibrinogen as a therapeutic target for bleeding: a review of critical levels and replacement therapy

2013

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Fibrinogen plays a critical role in achieving and maintaining hemostasis and is fundamental to effective clot formation. There is increasing awareness of the important role of fibrinogen as a key target for the treatment and prevention of acquired bleeding. Fibrinogen is the first coagulation factor to fall to critically low levels (<1.0 g/L) during major hemorrhage (normal plasma fibrinogen levels range from 2.0 to 4.5 g/L), and current guidelines recommend maintaining the plasma fibrinogen level above 1.5 g/L. Fibrinogen supplementation can be achieved using plasma or cryoprecipitate; however, there are a number of safety concerns associated with these allogeneic blood products and there is a lack of high-quality evidence to support their use. Additionally, there is sometimes a long delay associated with the preparation of frozen products for infusion. Fibrinogen concentrate provides a promising alternative to allogeneic blood products and has a number of advantages: it allows a standardized dose of fibrinogen to be rapidly administered in a small volume, has a very good safety profile, and is virally inactivated as standard. Administration of fibrinogen concentrate, often guided by point-of-care viscoelastic testing to allow individualized dosing, has been successfully used as hemostatic therapy in a range of clinical settings, including cardiovascular surgery, postpartum hemorrhage, and trauma. Results show that fibrinogen concentrate is associated with a reduction or even total avoidance of allogeneic blood product transfusion. Fibrinogen concentrate represents an important option for the treatment of coagulopathic bleeding; further studies are needed to determine precise dosing strategies and thresholds for fibrinogen supplementation.

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“…30 Factor II levels have been shown to decrease to ~50% of normal after CPB in patients undergoing complex cardiac surgery. 74 This is accompanied, however, by a similar decrease in anticoagulant factors (e.g., antithrombin III). Therefore, administering a dose of 4F-PCCs to achieve a 50% increase in factor II level may not be needed to ensure coagulation and could promote prothrombotic complications.…”

Section: Cardiac Surgery and Cardiopulmonary Bypassmentioning

confidence: 99%

“…Therefore, administering a dose of 4F-PCCs to achieve a 50% increase in factor II level may not be needed to ensure coagulation and could promote prothrombotic complications. 74 Similar to the use of initial INR values dictating PCC dosage administration for vitamin K antagonist reversal, 11 laboratory data-driven algorithms for bleeding will, therefore, guide therapy in the perioperative realm.…”

Section: Cardiac Surgery and Cardiopulmonary Bypassmentioning

confidence: 99%

Prothrombin Complex Concentrates for Bleeding in the Perioperative Setting

Ghadim

Levy

Welsby

2016

Survey of Anesthesiology

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Time Course of Haemostatic Effects of Fibrinogen Concentrate Administration in Aortic Surgery

Cited by 12 publications

References 9 publications

Introduction of an algorithm for ROTEM-guided fibrinogen concentrate administration in major obstetric haemorrhage

Introduction of an algorithm for ROTEM-guided fibrinogen concentrate administration in major obstetric haemorrhage

Fibrinogen as a therapeutic target for bleeding: a review of critical levels and replacement therapy

Prothrombin Complex Concentrates for Bleeding in the Perioperative Setting

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