Publication Date
1-1-2024
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
Biological Phenomena, Cell Phenomena, and Immunity Commons, Hematology Commons, Mental and Social Health Commons, Surgery Commons
Comments
PMID: 38596569