Anesthesia

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Finding the optimal concentration range for fibrinogen replacement after severe haemodilution: an in vitro model
British Journal of Anesthesia, 05/11/09

Bolliger D et al. - The target plasma concentration for fibrinogen replacement was predicted by these in vitro results to be greater than 200 mg dl–1 as only these concentrations optimized the rate of clot formation. This concentration is twice the level suggested by the current transfusion guidelines. Although improved, clots were prone to fibrinolysis indicating that the efficacy of fibrinogen therapy may be influenced by co-existing fibrinolytic tendency occurring during dilutional coagulopathy.

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