Pre-emptive administration of fibrinogen concentrate contributes to improved prognosis in patients with severe trauma

Trauma Surgery & Acute Care Open
Koji YamamotoSatoru Sugiyama

Abstract

Patients with severe trauma often present with critical coagulopathy, resulting in impaired hemostasis, massive hemorrhage, and a poor survival prognosis. The efficacy of hemostatic resuscitation in correcting coagulopathy and restoring tissue perfusion has not been studied. We assessed a novel approach of pre-emptive administration of fibrinogen concentrate to improve critical coagulopathy in patients with severe trauma. We retrospectively compared blood transfusion volumes and survival prognosis between three groups of patients with trauma, with an Injury Severity Score (ISS) ≥26 over three consecutive periods: group A, no administration of fibrinogen concentrate; group B, administration of 3 g of fibrinogen concentrate after evaluation of trauma severity and a plasma fibrinogen level <1.5 g/L; group C, pre-emptive administration of 3 g of fibrinogen concentrate immediately on patient arrival based on prehospital information, including high-severity injury or assessed need for massive transfusion before measurement of fibrinogen. ∼56% of patients with an ISS ≥26 and transfused with red blood cell concentrates ≥10 units, had hypofibrinogenemia (fibrinogen <1.5 g/L) on arrival. Patients who received fibrinogen concentrate in gr...Continue Reading

Citations

Sep 11, 2018·Critical Care Medicine·Samuel A Tisherman, Deborah M Stein
Sep 6, 2020·The Journal of Trauma and Acute Care Surgery·Sarah N StablerErik N Vu
Jan 6, 2021·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Vladimir ČernýHerbert Schöchl
Feb 9, 2021·Emergency Medicine Australasia : EMA·Daniel HarrisDaniel Y Ellis
Jun 3, 2021·Current Opinion in Anaesthesiology·Anna Roehl, Oliver Grottke
Jun 7, 2021·Current Opinion in Anaesthesiology·James WinearlsNicola Curry

❮ Previous
Next ❯

Methods Mentioned

BETA
ISS

Related Concepts

Related Feeds

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.

Related Papers

Critical Care : the Official Journal of the Critical Care Forum
Samuel A Tisherman
The Journal of Trauma and Acute Care Surgery
Sirat KhanInternational Trauma Research Network (INTRN)
[Rinshō ketsueki] The Japanese journal of clinical hematology
Koji Yamamoto
© 2022 Meta ULC. All rights reserved