About Acquired Bleeding and FibrinogenIn addition to bleeding caused by injury or a surgical intervention itself (surgical bleeding), critical reduction in the level of coagulation factors can lead to additional non-surgical bleeding complications that can be difficult to control (e.g., coagulopathic bleeding). Such patients can have critically low concentrations of many coagulation factors. In general, it is necessary to replace the missing coagulation factors in order to reverse the critical condition. The first factor to be depleted is fibrinogen (also called Factor I), a protein needed to form blood clots.  Fibrinogen levels in plasma determine the potential clotting ability and activity in the body. Diminished concentrations of fibrinogen limit the body's ability to form a clot. A simple blood test can detect the level of fibrinogen; the normal range is 150–450 milligrams per deciliter.  CPB-induced coagulopathy is complex. Fibrinogen is one of the coagulation factors to be significantly depleted during CPB; decreases in plasma level of 34 to 42 percent have been reported, and can increase the risk of post-operative bleeding. ,For nearly a hundred years the approach to managing bleeding has been simplistic; replacing loss of blood with blood. This currently standard approach is empirical and not based on rigorous scientific evidence. There is growing evidence that this may not be the most effective or appropriate approach.
Phase II Study Indicates That Fibrinogen Concentrate Given As A First-Line Therapy Safely Reduces Need For Transfusion After Aortic Surgery
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