Rapid measurement of fibrinogen concentration in whole blood using a steel ball coagulometer

The Journal of Trauma and Acute Care Surgery
Christoph J SchlimpHerbert Schöchl

Abstract

Fibrinogen plays a key role in hemostasis and is the first coagulation factor to reach critical levels in bleeding patients. Current European guidelines on the management of traumatic or perioperative bleeding recommend fibrinogen supplementation at specific threshold levels. Whole blood viscoelastic tests provide fast evaluation of fibrin deficits. Fast measurement of plasma fibrinogen concentration is not yet available. We investigated a method to rapidly determine whole blood fibrinogen concentration using standard Clauss assays and a steel ball coagulometer and provide an estimate of the "plasma-equivalent" fibrinogen concentration within minutes by adjustment of the measured whole blood fibrinogen concentration with a quickly measureable hemoglobin-derived hematocrit. The feasibility of this approach was tested with a Clauss assay using multiple porcine fresh blood samples obtained during in vivo bleeding, hemodilution, and after treatment with hemostatic therapy. Two different Clauss assays were then tested using multiple human volunteers' blood samples diluted in vitro and supplemented with fibrinogen concentrate. Comparative measurements with fibrin-based thromboelastometry tests were performed. Regression and Bland-Alt...Continue Reading

Citations

Sep 4, 2015·Journal of Thrombosis and Haemostasis : JTH·C SolomonM Ranucci
Apr 15, 2016·The Journal of Obstetrics and Gynaecology Research·Liangcheng WangHiroyuki Seki
Mar 29, 2019·Critical Care : the Official Journal of the Critical Care Forum·Donat R SpahnRolf Rossaint
Jul 4, 2020·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Nathan J WhiteJohn R Hess
Jan 23, 2020·Biomicrofluidics·Sarah E MenaMark A Burns

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