Fibrinogen Diagnostics in Major Hemorrhage

Abstract

Fibrinogen is one of the first factors to fall to critically low levels in the blood in many coagulopathic events. Patients with hypofibrinogenemia are at a significantly greater risk of major hemorrhage and death. The rapid replacement of fibrinogen early on in hypofibrinogenemia may significantly improve outcomes for patients. Fibrinogen is present at concentrations between 2 and 4 g/L in the plasma of healthy people. However, hypofibrinogenemia is diagnosed when the fibrinogen level drops below 1.5–2 g/L. This review analyses different types of fibrinogen assays that can be used for diagnosing hypofibrinogenemia. The scientific mechanisms and limitations behind these tests are then presented. Additionally, the current state of clinical major hemorrhage protocols (MHPs) is presented and the structure, function and physiological role of fibrinogen is summarized.

Keywords:

• Blood
• transfusion
• coagulopathy
• major hemorrhage
• fibrinogen concentration
• fibrinogen diagnostic

Acknowledgement

Many thanks to Dr. Zoe McQuilten for providing consultation on the clinical issues of this manuscript.

Disclosure statement

The authors declare no conflict of interest or commercial interest from the research.

Additional information

Funding

This research was funded by the Australian Research Council, ARC Linkage grant LP160100544 and Haemokinesis.