• Hamostaseologie · Jan 2014

    Review

    The role of fibrinogen in trauma-induced coagulopathy.

    • C J Schlimp and H Schöchl.
    • Herbert Schöchl, Assoc. Prof., Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Centre Vienna, Tel. +43/1/33 11 04 62, Fax +43/1/33 11 04 60, E-mail: herbert.schoechl@auva.at.
    • Hamostaseologie. 2014 Jan 1;34(1):29-39.

    AbstractFibrinogen plays an essential role in clot formation and stability. Importantly it seems to be the most vulnerable coagulation factor, reaching critical levels earlier than the others during the course of severe injury. A variety of causes of fibrinogen depletion in major trauma have been identified, such as blood loss, dilution, consumption, hyperfibrinolysis, hypothermia and acidosis. Low concentrations of fibrinogen are associated with an increased risk of diffuse microvascular bleeding. Therefore, repeated measurements of plasma fibrinogen concentration are strongly recommended in trauma patients with major bleeding. Recent guidelines recommend maintaining plasma fibrinogen concentration at 1.5-2 g/l in coagulopathic patients. It has been shown that early fibrinogen substitution is associated with improved outcome.

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