Fibrinogen supplementation ex vivo increasesclot firmness comparable to platelet transfusion in thrombocytopenia
| Autor: | Mirjam Bachler, Dieter Wally, Christian Fenger-Eriksen, Martin Hermann, Corinna Velik-Salchner, O.H. Larsen, Benjamin Treichl, A. K. Lindner, Dietmar Fries, Helmuth Tauber, Bettina Schenk |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Adolescent Platelet Transfusion 030204 cardiovascular system & hematology Pharmacology Fibrinogen 03 medical and health sciences Young Adult 0302 clinical medicine 030202 anesthesiology In vivo medicine Humans Platelet Blood Coagulation Whole blood Aged Aged 80 and over medicine.diagnostic_test business.industry Middle Aged Thrombocytopenia Thromboelastography Thrombelastography Thromboelastometry Anesthesiology and Pain Medicine Platelet transfusion Immunology Female Blood Coagulation Tests business Ex vivo medicine.drug |
| Zdroj: | Schenk, B, Lindner, A K, Treichl, B, Bachler, M, Hermann, M, Larsen, O H, Fenger-Eriksen, C, Wally, D, Tauber, H, Velik-Salchner, C & Fries, D 2016, ' Fibrinogen supplementation ex vivo increasesclot firmness comparable to platelet transfusion in thrombocytopenia ', British Journal of Anaesthesia, vol. 117, no. 5, pp. 576-582 . https://doi.org/10.1093/bja/aew315 Europe PubMed Central |
| ISSN: | 1471-6771 |
| DOI: | 10.1093/bja/aew315 |
| Popis: | BACKGROUND: Fibrinogen concentrate can improve clot firmness and offers a better safety profile than platelet concentrates. Reduction or avoidance of blood transfusions represents a strategy to reduce associated risks. We investigated whether supplementation of fibrinogen concentrate ex vivo can compensate for clot strength as compared with platelet transfusion in vivo METHODS: One hundred patients in need of platelet transfusion (PT) were enrolled. Blood samples were collected immediately before PT and at 1 h and 24 h after PT. Fibrinogen concentrate was added to these citrated whole blood samples at concentrations of 50, 100, 200 and 400 mg kg(-1) and the maximum clot firmness (MCF) was analysed using ROTEM thromboelastometry.RESULTS: Fibrinogen supplementation increased MCF significantly and dose-dependently before and after PT. The effect of fibrinogen concentrate (equivalent to doses of 100 and 200 mg kg(-1)) ex vivo was comparable to that of PT in vivo, whereas 400 mg kg(-1) fibrinogen significantly improved MCF compared with PT (P CONCLUSIONS: Fibrinogen concentrate can match the effect of PT on MCF in thrombocytopenia. This potential alternative haemostatic intervention should be evaluated in clinical trials. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|