Publication Date
4-3-2024
Journal
Trauma Surgery & Acute Care Open
Abstract
OBJECTIVES: Some centers have recommended including concentrated fibrinogen replacement in massive transfusion protocols (MTPs). Given our center's policy of aggressive early balanced resuscitation (1:1:1), beginning prehospital, we hypothesized that our rates of hypofibrinogenemia may be lower than those previously reported.
METHODS: In this retrospective cohort study, patients presenting to our trauma center November 2017 to April 2021 were reviewed. Patients were defined as hypofibrinogenemic (HYPOFIB) if admission fibrinogen
RESULTS: Of 29 782 patients, 6618 level 1 activations, and 1948 patients receiving emergency release blood,
CONCLUSIONS: Low rates of hypofibrinogenemia were found in our center which treats hemorrhage with early, balanced resuscitation. Previously reported higher rates may be partially due to unbalanced resuscitation and/or delay in resuscitation initiation. Routine empiric inclusion of concentrated fibrinogen replacement in MTPs is not supported by the currently available data.
LEVEL OF EVIDENCE: Level III.
Keywords
fibrinogen, wounds and injuries, resuscitation, Shock, Hemorrhagic
Included in
Hematology Commons, Hemic and Lymphatic Diseases Commons, Internal Medicine Commons, Medical Sciences Commons, Mental and Social Health Commons, Surgery Commons, Wounds and Injuries Commons
Comments
PMID: 38596569