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Báo cáo y học: " Effects of different fibrinogen concentrations on blood loss and coagulation parameters in a pig model of coagulopathy with blunt liver injury"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Effects of different fibrinogen concentrations on blood loss and coagulation parameters in a pig model of coagulopathy with blunt liver injury. | Grottke et al. Critical Care 2010 14 R62 http ccforum.eom content 14 2 R62 c CRITICAL CARE RESEARCH Open Access Effelcts of different fibrinogen concentrations on blood loss and coagulation parameters in a pig model of coagulopathy with blunt liver injury Oliver Grottke 1 2 Till Braunschweig3 Dietrich Henzler4 Mark Coburn1 Rene Tolba2 and Rolf Rossaint1 Abstract Introduction The early application of fibrinogen could potentially reverse haemodilution-induced coagulopathy although the impact of varying concentrations of fibrinogen to reverse dilutional coagulopathy has not been studied in vivo. We postulated that fibrinogen concentration is correlated with blood loss in a pig model of coagulopathy with blunt liver injury. Methods Coagulopathy was induced in 18 anaesthetized pigs 32 1.6 kg body weight by replacing 80 of blood volume with hydroxyethylstarch 130 0.4 and Ringer s lactated solution and re-transfusion of erythrocytes. Animals were randomly assigned to receive either 70 mg kg-1 F-70 or 200 mg kg-1 F-200 fibrinogen or placebo before inducing blunt liver injury using a force of 225 26 Newton. Haemodynamics coagulation parameters and blood loss were monitored for 2 hours. After death histological examination of internal organs was performed to assess the presence of emboli and the equality of liver injury. Results Plasma dilution caused severe coagulopathy. Measured by thromboelastography fibrinogen restored coagulation dose-dependently. Total blood loss was significantly lower and survival better in both fibrinogen groups as compared to controls P 0.05 . Between the F-70 1317 113 ml and the F-200 group 1155 232 ml no significant difference in total blood loss could be observed despite improved coagulation parameters in the F-200 group P 0.05 . Microscopy revealed even injury pattern and no micro thrombi for either group. Conclusions Restoring fibrinogen with 70 or 200 mg kg-1 after severe dilutional coagulopathy safely improved coagulation and attenuated .