Fibrinogen Metabolic Responses to Trauma
Abstract
Coagulation complications are significant contributors to morbidity and mortality in trauma patients. Although the lethal triad of hypothermia, acidosis and coagulopathy has been recognized for over a decade, the underlying mechanisms related to the development of coagulopathy remain unclear. Recent data suggest that decreased fibrinogen levels contribute to the development of coagulation disorders. Thus, regulation of fibrinogen availability, not fully understood at present, may play an important role in survival of trauma patients. This review summarizes the recent findings of the studies that have explored mechanisms related to changes in fibrinogen availability following trauma-related events. Trauma alters fibrinogen metabolism in a variety of ways: hemorrhage accelerated fibrinogen breakdown; hypothermia inhibited fibrinogen synthesis; and, acidosis accelerated fibrinogen breakdown. However, hemorrhage, hypothermia and cidosis all result in a consistent outcome of fibrinogen availability deficit, supporting the notion of fibrinogen supplementation in trauma patients with coagulation defects. Future prospective clinical trials are needed to confirm the beneficial effects of fibrinogen supplementation in trauma patients with bleeding complications.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 13, 2009
- Accession Number
- ADA627610
Entities
People
- Wenjun Zhou Martini
Organizations
- United States Army Institute of Surgical Research