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Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
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Early administration of fibrinogen concentrate in patients with polytrauma with thromboelastometry suggestive of

Lucas Siqueira de Lucena1,2, Roseny Dos Reis Rodrigues1, Maria José Carvalho Carmona1

  • 1Programa de Pos-graduacao em Anestesiologia, Ciencias Cirurgicas e Medicina Perioperatoria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.

Clinics (Sao Paulo, Brazil)
|November 10, 2021
PubMed

Insights

Early fibrinogen concentrate administration in severe trauma patients with hypofibrinogenemia is feasible. This intervention may reduce intensive care unit length of stay, warranting further investigation in larger clinical trials.

Area of Science:

  • Trauma care
  • Emergency medicine
  • Hematology

Background:

  • Severe trauma often leads to hypofibrinogenemia, a condition associated with increased mortality.
  • Early identification and management of hypofibrinogenemia are crucial in trauma resuscitation.

Purpose of the Study:

  • To evaluate the feasibility and clinical effects of early fibrinogen concentrate administration in severe trauma patients with hypofibrinogenemia.
  • To assess the impact on transfusion requirements and other clinical outcomes.

Main Methods:

  • An open randomized feasibility trial was conducted involving 32 severe trauma patients.
  • Patients with hypotension, tachycardia, and hypofibrinogenemia received either fibrinogen concentrate or standard care.
  • Feasibility was defined as treatment delivery within 60 minutes of randomization.

Main Results:

  • The study achieved 100% feasibility, with all patients receiving allocated treatment within 60 minutes.
  • The intervention group showed a significantly shorter intensive care unit (ICU) stay (8 vs. 11 days, p=0.02).
  • No significant differences were observed in other clinical outcomes or adverse events.

Conclusions:

  • Early fibrinogen replacement using fibrinogen concentrate is a feasible strategy in severe trauma with hypofibrinogenemia.
  • While feasibility is demonstrated, larger trials are necessary to confirm clinical benefits and efficacy.
Abstract

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