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Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
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Progression of Fibrinogen Decrease during High Dose Tigecycline Therapy in Critically Ill Patients: A Retrospective

Benedikt Treml1, Sasa Rajsic1, Tobias Hell2

  • 1General and Surgical Intensive Care Unit, Department of Anaesthesiology and Critical Care Medicine, Medical University Innsbruck, 6020 Innsbruck, Austria.

Journal of Clinical Medicine
|October 23, 2021
PubMed
Summary
This summary is machine-generated.

Tigecycline treatment in critically ill patients can cause hypofibrinogenemia. Higher doses and longer tigecycline treatment duration correlate with greater fibrinogen decrease, potentially due to impaired liver synthesis during inflammation.

Keywords:
antibioticscoagulation disordercoagulopathyglycylcyclinehypofibrinogenemiainfectiontigecyclinetygacil

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Area of Science:

  • Pharmacology
  • Critical Care Medicine
  • Hematology

Background:

  • Tigecycline is a broad-spectrum antibiotic used for complicated infections in critically ill patients.
  • A known adverse effect of tigecycline is coagulopathy, specifically hypofibrinogenemia.
  • Limited data exists on risk factors and outcomes associated with tigecycline-induced coagulopathy.

Purpose of the Study:

  • To investigate the time-course of fibrinogen level changes during tigecycline therapy.
  • To identify risk factors contributing to tigecycline-induced coagulopathy.
  • To report on clinically significant outcomes in patients receiving tigecycline.

Main Methods:

  • Retrospective review of 130 intensive care unit patients treated with tigecycline from 2010 to 2018.
  • Stratification of patients into two groups based on the degree of fibrinogen decrease.
  • Analysis of patient data including tigecycline dosage, treatment duration, inflammation markers, and liver synthesis capacity.

Main Results:

  • Patients with greater fibrinogen decrease received higher tigecycline doses and longer treatment durations.
  • Higher inflammation markers and reduced liver synthesis capacity were observed in patients with significant fibrinogen decrease.
  • The findings suggest tigecycline-induced hypofibrinogenemia may be exacerbated by impaired liver synthesis in severe inflammatory states.

Conclusions:

  • Tigecycline therapy can lead to significant fibrinogen level decrease in critically ill patients.
  • Risk factors include higher dosage, prolonged treatment, and underlying severe inflammation impacting liver function.
  • Cautious coagulation monitoring is recommended for critically ill patients receiving high-dose tigecycline to mitigate bleeding risk.