• Clin. Appl. Thromb. Hemost. · Jul 2013

    Case Reports

    Severe pediatric blunt trauma--successful ROTEM-guided hemostatic therapy with fibrinogen concentrate and no administration of fresh frozen plasma or platelets.

    • Bernhard Ziegler, Christa Schimke, Peter Marchet, Birgit Stögermüller, Herbert Schöchl, and Cristina Solomon.
    • Department of Anaesthesiology, Perioperative Medicine and General Intensive Care, SALK University Hospital, Salzburg, Austria.
    • Clin. Appl. Thromb. Hemost. 2013 Jul 1;19(4):453-9.

    AbstractUse of allogeneic blood products to treat pediatric trauma may be challenged, particularly in relation to safety. We report successful treatment of a child with severe abdominal and pelvic injuries with preemptive fibrinogen supplementation followed by rotational thromboelastometry (ROTEM)-guided, goal-directed hemostatic therapy. Fibrinogen concentrate was administered (total dose: 2 g), while transfusion of fresh frozen plasma and platelet concentrate was avoided. Activated partial thromboplastin time was prolonged and Quick values were low but ROTEM clotting time values remained normal, therefore, no thrombin-generating drugs were considered necessary. This case shows the potential for hemostatic treatment with coagulation factor concentrates to be applied to pediatric trauma.

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