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  • Pre-emptive...

Pre-emptive administration of fibrinogen concentrate effective in severe trauma: BMJ

Dr. Shravani DaliWritten by Dr. Shravani Dali Published On 2021-11-25T10:00:43+05:30  |  Updated On 2021-11-25T10:06:07+05:30
Pre-emptive administration of fibrinogen concentrate effective in severe trauma: BMJ

Pre-emptive administration of fibrinogen concentrates effective in severe trauma, according to a recent study published in the BMJ Journals: Trauma Surgery & Acute Care. Patients with severe trauma often present with critical coagulopathy, resulting in impaired hemostasis, massive haemorrhage, and a poor survival prognosis. The efficacy of hemostatic resuscitation...

Pre-emptive administration of fibrinogen concentrates effective in severe trauma, according to a recent study published in the BMJ Journals: Trauma Surgery & Acute Care.

Patients with severe trauma often present with critical coagulopathy, resulting in impaired hemostasis, massive haemorrhage, and a poor survival prognosis. The efficacy of hemostatic resuscitation in correcting coagulopathy and restoring tissue perfusion has not been studied. We assessed a novel approach of pre-emptive administration of fibrinogen concentrate to improve critical coagulopathy in patients with severe trauma.

The researchers retrospectively compared blood transfusion volumes and survival prognosis between three groups of patients with trauma, with an Injury Severity Score (ISS) ≥26 over three consecutive periods: group A, no administration of fibrinogen concentrate; group B, administration of 3 g of fibrinogen concentrate after evaluation of trauma severity and a plasma fibrinogen level <1.5 g/L; group C, pre-emptive administration of 3 g of fibrinogen concentrate immediately on patient arrival based on prehospital information, including high-severity injury or assessed need for massive transfusion before measurement of fibrinogen.

The Results of the study are as follows:

∼56% of patients with an ISS ≥26 and transfused with red blood cell concentrates ≥10 units, had hypofibrinogenemia (fibrinogen <1.5 g/L) on arrival. Patients who received fibrinogen concentrate in group C showed significantly higher fibrinogen levels after treatment with this agent than those in group B (2.41 g/L vs 1.88 g/L; p=0.01). Although no significant difference was observed in blood transfusion volumes between the groups, the 30-day survival of patients in group C (all, and those with an ISS ≥26) was significantly better than in group A (p<0.05). The 48-hour mortality rate in patients with an ISS ≥26 was significantly lower in group C than in group A (8.6% vs 22.9%; p=0.005). Further, among patients with an ISS ≥41, the overall mortality was significantly lower in group C than in group A (20% vs 50%; p=0.02).

Thus, the researchers concluded that pre-emptive administration of fibrinogen concentrate for patients with trauma with critical coagulopathy may contribute to improved survival.

Reference:

Pre-emptive administration of fibrinogen concentrate contributes to improved prognosis in patients with severe trauma by Koji Yamamoto et al. published in the BMJ Journals: Trauma Surgery & Acute Care.

https://tsaco.bmj.com/content/1/1/e000037


fibrinogen concentrate pre-emptive administration severe trauma prognosis BMJ Journals: Trauma Surgery & Acute Care 
Source : BMJ Journals: Trauma Surgery & Acute Care
Dr. Shravani Dali
Dr. Shravani Dali

    BDS

    Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

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