title: Fibrinogen in traumatic haemorrhage: A narrative review.
abstract: Haemorrhage in the setting of severe trauma is associated with significant morbidity and mortality. There is increasing awareness of the important role fibrinogen plays in traumatic haemorrhage. Fibrinogen levels fall precipitously in severe trauma and the resultant hypofibrinogenaemia is associated with poor outcomes. Hence, it has been postulated that early fibrinogen replacement in severe traumatic haemorrhage may improve outcomes, although, to date there is a paucity of high quality evidence to support this hypothesis. In addition there is controversy regarding the optimal method for fibrinogen supplementation. We review the current evidence regarding the role of fibrinogen in trauma, the rationale behind fibrinogen supplementation and discuss current research.
authors.affiliation: Gold Coast University Hospital, Australia; School of Medical Sciences, Griffith University, Australia; School of Medicine, University of Queensland, Australia. Electronic address: james.winearls@health.qld.gov.au.
authors.forename: James
authors.initials: J
authors.lastname: Winearls
authors.affiliation: Gold Coast University Hospital, Australia. Electronic address: don.campbell@health.qld.gov.au.
authors.forename: Don
authors.initials: D
authors.lastname: Campbell
authors.affiliation: Royal Brisbane and Women's Hospital, Australia; School of Medicine, University of Queensland, Australia. Electronic address: catherine.hurn@health.qld.gov.au.
authors.forename: Catherine
authors.initials: C
authors.lastname: Hurn
authors.affiliation: Townsville Hospital, Australia. Electronic address: jeremy.furyk@health.qld.gov.au.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Furyk
authors.affiliation: Princess Alexandra Hospital, Australia. Electronic address: glenn.ryan@health.qld.gov.au.
authors.forename: Glenn
authors.initials: G
authors.lastname: Ryan
authors.affiliation: Townsville Hospital, Australia. Electronic address: melita.trout@health.qld.gov.au.
authors.forename: Melita
authors.initials: M
authors.lastname: Trout
authors.affiliation: Princess Alexandra Hospital, Australia; School of Medicine, University of Queensland, Australia. Electronic address: james.walsham@health.qld.gov.au.
authors.forename: James
authors.initials: J
authors.lastname: Walsham
authors.affiliation: Royal Brisbane and Women's Hospital, Australia; School of Medicine, University of Queensland, Australia. Electronic address: anthony.holley@health.qld.gov.au.
authors.forename: Anthony
authors.initials: A
authors.lastname: Holley
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Australia. Electronic address: m.shuttleworth@griffith.edu.au.
authors.forename: Megan
authors.initials: M
authors.lastname: Shuttleworth
authors.affiliation: Australian Red Cross Blood Service, Australia. Electronic address: W.Dyer@redcrossblood.org.au.
authors.forename: Wayne
authors.initials: W
authors.lastname: Dyer
authors.affiliation: Gold Coast University Hospital, Australia; School of Medical Sciences, Griffith University, Australia; School of Medicine, Bond University, Australia. Electronic address: gerben.keijzers@health.qld.gov.au.
authors.forename: Gerben
authors.initials: G
authors.lastname: Keijzers
authors.affiliation: Royal Melbourne Hospital, Australia. Electronic address: jeffrey.presneill@health.qld.gov.au.
authors.forename: Jeff
authors.initials: J
authors.lastname: Presneill
authors.affiliation: School of Medicine, University of Queensland, Australia; The Prince Charles Hospital, Australia. Electronic address: john.fraser@health.qld.gov.au.
authors.forename: John F
authors.initials: JF
authors.lastname: Fraser
authors.affiliation: Gold Coast University Hospital, Australia; School of Medical Sciences, Griffith University, Australia. Electronic address: martin.wullschleger@health.qld.gov.au.
authors.forename: Martin
authors.initials: M
authors.lastname: Wullschleger
mesh_terms: D001315:Australia / Q000453:epidemiology; D006259:Craniocerebral Trauma / Q000150:complications / Q000401:mortality / Q000628:therapy*; D005340:Fibrinogen / Q000627:therapeutic use*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D020198:Intracranial Hemorrhage, Traumatic / Q000150:complications / Q000401:mortality / Q000628:therapy*; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics; D005340:Fibrinogen
keywords: Coagulopathy; Cryoprecipitate; Fibrinogen; Fibrinogen concentrate; Massive transfusion; Trauma; Viscoelastic haemostatic assays