Journal ArticleDOI
Fibrinogen and hemostasis: a primary hemostatic target for the management of acquired bleeding.
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TLDR
The prospective study of fibrinogen supplementation in acquired bleeding is needed to accurately assess the range of clinical settings in which this management strategy is appropriate, the most effective method of supplementation and a comprehensive safety profile of fibinogen concentrate used for such an approach.Abstract:
Fibrinogen plays several key roles in the maintenance of hemostasis. Its cleavage by thrombin and subsequent polymerization to form fibrin strands provides the structural network required for effective clot formation. During cases of acute blood loss, attempts to maintain circulating volume and tissue perfusion often involve the infusion of crystalloids, colloids, and red blood cells. Intravascular volume resuscitation, although vital, frequently results in dilution of the remaining clotting factors and onset of dilutional coagulopathy. In such cases, fibrinogen is the first coagulation factor to decrease to critically low levels. There currently is a lack of awareness among physicians regarding the significance of fibrinogen during acute bleeding and, at many centers, fibrinogen is not monitored routinely during treatment. We reviewed current studies that demonstrate the importance of considering fibrinogen replacement during the treatment of acquired bleeding across clinical settings. If depleted, the supplementation of fibrinogen is key for the rescue and maintenance of hemostatic function; however, the threshold at which such intervention should be triggered is currently poorly defined. Although traditionally performed via administration of fresh frozen plasma or cryoprecipitate, the use of lyophilized fibrinogen (concentrate) is becoming more prevalent in some countries. Recent reports relating to the efficacy of fibrinogen concentrate suggest that it is a viable alternative to traditional hemostatic approaches, which should be considered. The prospective study of fibrinogen supplementation in acquired bleeding is needed to accurately assess the range of clinical settings in which this management strategy is appropriate, the most effective method of supplementation and a comprehensive safety profile of fibrinogen concentrate used for such an approach.read more
Citations
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Journal ArticleDOI
NLRP3 inflammasome: From a danger signal sensor to a regulatory node of oxidative stress and inflammatory diseases
Amna Abderrazak,Tatiana Syrovets,Dominique Couchie,Khadija El Hadri,Bertrand Friguet,Thomas Simmet,Mustapha Rouis,Mustapha Rouis,Mustapha Rouis +8 more
TL;DR: This review has updated knowledge on NLRP3 inflammasome assembly and activation and on the pyrin domain inNLRP3 that could represent a drug target to treat sterile inflammatory diseases, and reported mutations in NL RP3 that were found to be associated with certain diseases.
Journal ArticleDOI
Fibrinogen as a therapeutic target for bleeding: a review of critical levels and replacement therapy.
TL;DR: Results show that fibrinogen concentrate is associated with a reduction or even total avoidance of allogeneic blood product transfusion, and represents an important option for the treatment of coagulopathic bleeding; further studies are needed to determine precise dosing strategies and thresholds for fibr inogen supplementation.
Journal ArticleDOI
Concepts of blood transfusion in adults
TL;DR: Institutional experience and national databases suggest that a restrictive blood transfusion approach is being increasingly implemented as best practice.
Journal ArticleDOI
Trauma-induced coagulopathy.
Ernest E. Moore,Hunter B. Moore,Lucy Z. Kornblith,Matthew D. Neal,Maureane Hoffman,Nicola J. Mutch,Herbert Schöchl,Beverley J Hunt,Angela Sauaia,Angela Sauaia +9 more
TL;DR: In the early hours of TIC development, hypocoagulability is typically present, resulting in bleeding, whereas later TIC is characterized by a hypercoagulable state associated with venous thromboembolism and multiple organ failure.
Journal ArticleDOI
Evaluation and management of postpartum hemorrhage: consensus from an international expert panel
Rezan Abdul-Kadir,Claire McLintock,Anne Sophie Ducloy,Hazem El-Refaey,Adrian England,Augusto B. Federici,Chad A. Grotegut,Susan Halimeh,Jay H. Herman,Stefan Hofer,Andra H. James,Peter A. Kouides,Michael J. Paidas,Flora Peyvandi,Rochelle Winikoff +14 more
TL;DR: Postpartum hemorrhage remains one of the leading causes of maternal morbidity and mortality worldwide, although the lack of a precise definition precludes accurate data of the absolute prevalence of PPH.
References
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Journal ArticleDOI
Mortality by cause for eight regions of the world: Global Burden of Disease Study
TL;DR: The Global Burden of Disease Study (GBD) used various data sources and made corrections for miscoding of important diseases (eg, ischaemic heart disease) to estimate worldwide and regional cause-of-death patterns in 1990, and the estimates by cause provide a foundation for a more informed debate on public-health priorities.
Journal ArticleDOI
Fibrinogen and fibrin structure and functions.
TL;DR: In addition to its primary role of providing scaffolding for the intravascular thrombus and also accounting for important clot viscoelastic properties, fibrin(ogen) participates in other biologic functions involving unique binding sites, some of which become exposed as a consequence of fibrIn formation.
Journal ArticleDOI
Fibrinogen and risk of cardiovascular disease. The Framingham Study.
TL;DR: The impact of fibrinogen value, considered as a separate variable, on cardiovascular disease was comparable with the major risk factors, such as blood pressure, hematocrit, adiposity, cigarette smoking, and diabetes and was significantly related to these risk factors.
Journal ArticleDOI
Acute traumatic coagulopathy.
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Journal ArticleDOI
The Ratio of Blood Products Transfused Affects Mortality in Patients Receiving Massive Transfusions at a Combat Support Hospital
Matthew A. Borgman,Philip C. Spinella,Jeremy G. Perkins,Kurt W. Grathwohl,Thomas Repine,Alec C. Beekley,James A. Sebesta,Donald H. Jenkins,Charles E. Wade,John B. Holcomb +9 more
TL;DR: In patients with combat-related trauma requiring massive transfusion, a high 1:1.4 plasma to RBC ratio is independently associated with improved survival to hospital discharge, primarily by decreasing death from hemorrhage.
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