Fibrinogen in traumatic haemorrhage: A narrative review

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• 作者：James Winearls^a ; ^b ; ^f ; ^{james.winearls@health.qld.gov.au} ; ^{james.winearls@gmail.com} ; Don Campbell^a ; ^{don.campbell@health.qld.gov.au} ; Catherine Hurn^c ; ^f ; ^{catherine.hurn@health.qld.gov.au} ; Jeremy Furyk^d ; ^{jeremy.furyk@health.qld.gov.au} ; Glenn Ryan^e ; ^{glenn.ryan@health.qld.gov.au} ; Melita Trout^d ; ^{melita.trout@health.qld.gov.au} ; James Walsham^e ; ^f ; ^{james.walsham@health.qld.gov.au} ; Anthony Holley^c ; ^f ; ^{anthony.holley@health.qld.gov.au} ; Megan Shuttleworth^g ; ^{m.shuttleworth@griffith.edu.au} ; Wayne Dyer^h ; ^{W.Dyer@redcrossblood.org.au} ; Gerben Keijzers^a ; ^b ; ⁱ ; ^{gerben.keijzers@health.qld.gov.au} ; Jeff Presneill^j ; ^{jeffrey.presneill@health.qld.gov.au} ; John F. Fraser^f ; ^k ; ^{john.fraser@health.qld.gov.au} ; Martin Wullschleger^a ; ^b ; ^{martin.wullschleger@health.qld.gov.au}
• 关键词：A5 (A10) ; amplitude of clot firmness 5 (10) minutes after CT ; BW ; body weight ; CFT ; clot formation time ; Cryo ; cryoprecipitate ; CT ; clotting time ; DCR ; damage control resuscitation ; ED ; Emergency Department ; FC ; fibrinogen concentrate ; FibC ; clauss fibrinogen ; FFP ; fresh frozen plasma ; GCUH ; Gold Coast University Hospital ; Queensland ; Australia ; Hb ; Hemoglobin ; ICU ; intensive care unit ; MCF ; maximum clot firmness ; MHP ; major haemorrhage protocol ; OR ; operating room ; rPT ; rapid prothrombin time
• 刊名：Injury
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：48
• 期：2
• 页码：230-242
• 全文大小：2889 K
• 卷排序：48

文摘

Haemorrhage in the setting of severe trauma is associated with significant morbidity and mortality. There is increasing awareness of the important role fibrinogen plays in traumatic haemorrhage. Fibrinogen levels fall precipitously in severe trauma and the resultant hypofibrinogenaemia is associated with poor outcomes. Hence, it has been postulated that early fibrinogen replacement in severe traumatic haemorrhage may improve outcomes, although, to date there is a paucity of high quality evidence to support this hypothesis. In addition there is controversy regarding the optimal method for fibrinogen supplementation. We review the current evidence regarding the role of fibrinogen in trauma, the rationale behind fibrinogen supplementation and discuss current research.