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Fibrinogen Deficiency in Bleeding Learning Zone

ISICEM 2019

Read time: 60 mins
Last updated:11th Oct 2022
Published:14th May 2020

In March 2019, experts from around the globe travelled to Brussels for the 39th International Symposium on Intensive Care and Emergency Medicine (ISICEM). Attracting more than 6,200 participants, ISICEM is dedicated to sharing the latest developments in critical care and emergency medicine. Video footage from the CSL Behring sponsored satellite symposium, featuring topics such as trauma induced coagulopathy and the critical reduction of fibrinogen, can be found below.

Professor Donat Spahn

Meet the expert

Donat Spahn is a Professor of Anaesthesiology and Chairman of the Institute of Anaesthesiology at University Hospital Zürich, Switzerland.

The elements of trauma induced coagulopathy

Professor Donat Spahn discusses the elements of trauma induced coagulopathy (TIC) from pre-existing conditions and co-morbidities to tissue damage and haemorrhage and the eventual critical reduction of coagulation factors, such as fibrinogen, through various mechanisms.

Coagulopathy is frequent after major trauma and fibrinogen becomes critically reduced first in many trauma patients. Watch to discover the elements of TIC from initial tissue damage to the critical reduction of coagulation factors.

Updates to the European guideline on the management of major bleeding following trauma

Announcing the launch of the 5th Edition of the European guideline on the management of major bleeding following trauma and noting new changes, Professor Donat R. Spahn shares new updates and stresses that compliance with this new guideline improves survival.

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Dr Daniel Dirkmann

Meet the expert

Daniel Dirkmann is Associate of Anaesthesiology and Intensive Care Medicine at Essen University Hospital, Germany.

Is viscoelastic testing better than standard plasmatic coagulation testing?

Coagulopathy increases mortality in trauma patients, yet testing is blind to coagulation. In this video, Dr Daniel Dirkmann describes the two schools of thought – an immediate and simple transfusion package or a more investigative method. He also discusses the issues with current laboratory testing and the benefits of viscoelastic testing.

Despite the link between mortality and coagulopathy, current testing is slow and does not yield enough information on coagulation. Find out why Dr Daniel Dirkmann suggests that an investigative method, with viscoelastic testing, may provide better results.

The advantages of thromboelastometry over standard plasmatic coagulation testing

In this video, Dr Daniel Dirkmann shares data showing that thromboelastometry (ROTEM) is a faster investigatory method than standard plasmatic coagulation testing. He also describes how a ROTEM graph can reveal a wide range of information on the patient and how this can be used to determine the best treatment options.

Coagulation testing needs to be faster and give more detailed information. Find out how viscoelastic testing is faster and yields more results than standard plasmatic coagulation testing. Also learn how thromboelastometry can reveal information on thrombin generation, fibrin concentration and polymerisation, fibrin platelet interaction and fibrinolysis alterations.

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Professor Petra Innerhofer

Meet the expert

Petra Innerhofer is a Professor and Head of Department of Anaesthesiology and Intensive Care Medicine at Innsbruck Medical University, Austria.

Are coagulation factor concentrates more effective than fresh frozen plasma?

A complex sequence of processes is induced if hypoperfusion develops, so what specifically stops bleeding? In this video, Professor Petra Innerhofer describes the question of whether elevating the concentration of all coagulation factors is sufficient to stop bleeding or if fibrinogen concentrate alone would be more effective.

Early effective correction of hypofibrinogenemia is really important. With a complex sequence of processes induced if hypoperfusion develops, Professor Petra Innerhofer questions whether fibrinogen concentrate alone is sufficient to stop major bleeding compared to FFP.

Comparing coagulation factor concentrates against fresh frozen plasma: the RETIC trial

Professor Petra Innerhofer describes the study design of the RETIC (Reversal of TIC using first-line coagulation factor concentrates (CFC) or FFP) single-centre, parallel-group, open-label, randomized trial. The RETIC trial assessed the superiority of CFC, mainly fibrinogen concentrate, to FFP based therapy in adult patients with major trauma.

Find out how the RETIC single-centre, parallel-group, open-label, randomized trial was designed to assess the superiority of CFC to FFP. Also learn why difference between the groups in the rate of multi-organ failure (MOF) was chosen as the primary endpoint.

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