Fibrinogen in traumatic haemorrhage

Area of Science:

• Trauma and Emergency Medicine
• Hematology
• Critical Care

Background:

• Traumatic hemorrhage and trauma-induced coagulopathy (TIC) are significant causes of mortality in severely injured patients.
• Despite advances, hemorrhage remains a leading cause of death, highlighting the need for effective management strategies.

Purpose of the Study:

• To review the role of fibrinogen in normal hemostasis.
• To examine the impact of trauma and TIC on fibrinogen levels.
• To evaluate the current evidence for fibrinogen replacement in managing traumatic hemorrhage.

Main Methods:

• Literature review of studies on fibrinogen in trauma.
• Analysis of the association between fibrinogen levels, massive transfusion, and mortality.
• Assessment of evidence for fibrinogen concentrate and cryoprecipitate use.

Main Results:

• Fibrinogen is often the first factor to become critically low in traumatic hemorrhage.
• Hypofibrinogenemia post-trauma is linked to increased risks of massive transfusion and death.
• Evidence supporting early fibrinogen replacement or specific replacement products is currently limited.

Conclusions:

• Fibrinogen is crucial for effective hemostasis and clot formation.
• Pilot trials have explored fibrinogen replacement strategies in severe trauma.
• Large-scale trials are underway to establish a robust evidence base for managing major hemorrhage in trauma patients.