Acquired hypofibrinogenemia: current perspectives

Abstract

Acquired hypofibrinogenemia is most frequently caused by hemodilution and consumption of clotting factors. The aggressive replacement of fibrinogen has become one of the core principles of modern management of massive hemorrhage. The best method for determining the patient’s fibrinogen level remains controversial, and particularly in acquired dysfibrinogenemia, could have major therapeutic implications depending on which quantification method is chosen. This review introduces the available laboratory and point-of-care methods and discusses the relative advantages and limitations. It also discusses current strategies for the correction of hypofibrinogenemia.

Keywords:

• Clauss fibrinogen assay
• fibrinogen antigen
• viscoelastic testing
• gravimetric fibrinogen assay
• PT-derived fibrinogen
• functional fibrinogen
• direct oral anticoagulant
• dysfibrinogenemia
• afibrinogenemia

Disclosure

Dr M Besser has received a fee from Glaxo Smith Kline for chairing a meeting and has previously received a travel grant from CSL Behring. The authors report no other conflicts of interest in this work.