Correction of hypothermic and dilutional coagulopathy with concentrates of fibrinogen and factor XIII: an in vitro study with ROTEM
(2014) In Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 22.- Abstract
- Background: Fibrinogen concentrate treatment can improve coagulation during massive traumatic bleeding. The aim of this in vitro study was to determine whether fibrinogen concentrate, or a combination of factor XIII and fibrinogen concentrates, could reverse a haemodilution-induced coagulopathy during hypothermia. Methods: Citrated venous blood from 10 healthy volunteers was diluted in vitro by 33% with 130/0.42 hydroxyethyl starch (HES) or Ringer's acetate (RAc). The effects of fibrinogen concentrate corresponding to 4 gram per 70 kg, or a combination of the same dose of fibrinogen with factor XIII (20 IU per kg), were measured using rotational thromboelastometry (ROTEM). The blood was analysed at 33 degrees C or 37 degrees C with ROTEM... (More)
- Background: Fibrinogen concentrate treatment can improve coagulation during massive traumatic bleeding. The aim of this in vitro study was to determine whether fibrinogen concentrate, or a combination of factor XIII and fibrinogen concentrates, could reverse a haemodilution-induced coagulopathy during hypothermia. Methods: Citrated venous blood from 10 healthy volunteers was diluted in vitro by 33% with 130/0.42 hydroxyethyl starch (HES) or Ringer's acetate (RAc). The effects of fibrinogen concentrate corresponding to 4 gram per 70 kg, or a combination of the same dose of fibrinogen with factor XIII (20 IU per kg), were measured using rotational thromboelastometry (ROTEM). The blood was analysed at 33 degrees C or 37 degrees C with ROTEM EXTEM and FIBTEM reagents. Clotting time (CT), clot formation time (CFT), alpha angle (AA) and maximal clot formation (MCF) were recorded. Results: Fibrinogen with or without factor XIII improved all ROTEM parameters in either solution irrespective of temperature, with the exception of EXTEM-AA and EXTEM-CFT in HES haemodilution. Fibrinogen increased FIBTEM-MCF more in the samples diluted with RAc than HES, particularly in presence of factor XIII. Conclusions: Fibrinogen improved in vitro haemodilution-induced coagulopathy at both 33 degrees C and 37 degrees C, though more efficiently after crystalloid than HES haemodilution. Factor XIII had an additional effect on FIBTEM-MCF, but only after crystalloid dilution. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4941413
- author
- Winstedt, Dag
LU
; Thomas, Owain
LU
; Nilsson, Fredrik ; Olanders, Knut LU and Schött, Ulf LU
- organization
- publishing date
- 2014
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Factor XIII, Fibrinogen, Hemodilution, Hypothermia, Hemostasis, Thrombelastography
- in
- Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
- volume
- 22
- article number
- 73
- publisher
- BioMed Central (BMC)
- external identifiers
-
- wos:000346873200001
- pmid:25510409
- scopus:84989295852
- ISSN
- 1757-7241
- DOI
- 10.1186/s13049-014-0073-z
- project
- Koagulation vid kirurgi och kritisk sjukdom
- language
- English
- LU publication?
- yes
- id
- b422692c-7d5a-4a23-815c-a122a7af8ac7 (old id 4941413)
- date added to LUP
- 2016-04-01 14:27:49
- date last changed
- 2022-01-28 00:46:22
@article{b422692c-7d5a-4a23-815c-a122a7af8ac7, abstract = {{Background: Fibrinogen concentrate treatment can improve coagulation during massive traumatic bleeding. The aim of this in vitro study was to determine whether fibrinogen concentrate, or a combination of factor XIII and fibrinogen concentrates, could reverse a haemodilution-induced coagulopathy during hypothermia. Methods: Citrated venous blood from 10 healthy volunteers was diluted in vitro by 33% with 130/0.42 hydroxyethyl starch (HES) or Ringer's acetate (RAc). The effects of fibrinogen concentrate corresponding to 4 gram per 70 kg, or a combination of the same dose of fibrinogen with factor XIII (20 IU per kg), were measured using rotational thromboelastometry (ROTEM). The blood was analysed at 33 degrees C or 37 degrees C with ROTEM EXTEM and FIBTEM reagents. Clotting time (CT), clot formation time (CFT), alpha angle (AA) and maximal clot formation (MCF) were recorded. Results: Fibrinogen with or without factor XIII improved all ROTEM parameters in either solution irrespective of temperature, with the exception of EXTEM-AA and EXTEM-CFT in HES haemodilution. Fibrinogen increased FIBTEM-MCF more in the samples diluted with RAc than HES, particularly in presence of factor XIII. Conclusions: Fibrinogen improved in vitro haemodilution-induced coagulopathy at both 33 degrees C and 37 degrees C, though more efficiently after crystalloid than HES haemodilution. Factor XIII had an additional effect on FIBTEM-MCF, but only after crystalloid dilution.}}, author = {{Winstedt, Dag and Thomas, Owain and Nilsson, Fredrik and Olanders, Knut and Schött, Ulf}}, issn = {{1757-7241}}, keywords = {{Factor XIII; Fibrinogen; Hemodilution; Hypothermia; Hemostasis; Thrombelastography}}, language = {{eng}}, publisher = {{BioMed Central (BMC)}}, series = {{Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine}}, title = {{Correction of hypothermic and dilutional coagulopathy with concentrates of fibrinogen and factor XIII: an in vitro study with ROTEM}}, url = {{https://lup.lub.lu.se/search/files/3992691/7689506}}, doi = {{10.1186/s13049-014-0073-z}}, volume = {{22}}, year = {{2014}}, }