The Effects of Fibrinogen Levels on Thromboelastometric Variables in the Presence of Thrombocytopenia

@article{Lang2009TheEO,
  title={The Effects of Fibrinogen Levels on Thromboelastometric Variables in the Presence of Thrombocytopenia},
  author={Thomas Lang and Kai Johanning and Helfried Metzler and Siegfried Piepenbrock and Cristina Solomon and N Rahe-meyer and Kenichi A Tanaka},
  journal={Anesthesia \& Analgesia},
  year={2009},
  volume={108},
  pages={751-758}
}
BACKGROUND: The binding of fibrinogen and fibrin to platelets is important in normal hemostasis. The extent of platelet-fibrin interaction can be measured as the viscoelastic strength of clot by rotational thromboelastometry (ROTEM®). In this study, we investigated the effect of fibrinogen concentration and its relative contribution to overall clot strength using ROTEM. METHODS: Blood samples were collected from healthy volunteers. The effects of platelet count on clot strength, determined by… 
Assessing the Methodology for Calculating Platelet Contribution to Clot Strength (Platelet Component) in Thromboelastometry and Thrombelastography
TLDR
The basis for why this calculation should be based on clot elasticity as opposed to clot amplitude is reviewed, which can provide a valuable insight into platelet deficiency in emergency bleeding.
In vitro comparative study of hemostatic components in warfarin-treated and fibrinogen-deficient plasma.
TLDR
Cryoprecipitate supports clot formation on ROTEM more efficiently than FFP because of the high fibrinogen content, which is presumably caused by increased interaction among thrombin-activated platelets and fibr inogen.
Differential Roles of Fibrinogen and von Willebrand Factor on Clot Formation and Platelet Adhesion in Reconstituted and Immune Thrombocytopenia
TLDR
It is demonstrated that in most cases of ITP, platelet function is comparable to normal platelets and vWF and fibrinogen differentially affect primary and secondary hemostasis and therefore both may perform a function in the bleeding phenotype and possibly may be considered for treatment in patients with ITP.
FIBTEM PLUS Provides an Improved Thromboelastometry Test for Measurement of Fibrin-Based Clot Quality in Cardiac Surgery Patients
TLDR
A novel test for measuring fibrin-based clotting, FIBTEM PLUS, in cardiac surgery is investigated and it provides greater inhibition of platelets than FibTEM, but there is no meaningful difference between FIBtEM PLUS and F IBTEM in patients with low platelet counts.
In vitro evaluation of clot quality and stability in a model of severe thrombocytopenia: effect of fibrinogen, factor XIII and thrombin-activatable fibrinolysis inhibitor.
TLDR
Augmentation of clot formation and anti-fibrinolysis by combining fib, FXIII and TAFI may be beneficial for the treatment of patients with severe thrombocytopenia especially when complicated by haemodilution following introduction of fluids to compensate for massive blood loss.
Comparison of Whole Blood Fibrin-Based Clot Tests in Thrombelastography and Thromboelastometry
TLDR
Differences when measuring fibrin-based clotting via the FF and FIBTEM assays on the TEG® and ROTEM® devices demonstrate that point-of-care targeted correction of fibrIn- based clotting may be influenced by the assay and device used.
Fibrinogen supplementation ex vivo increasesclot firmness comparable to platelet transfusion in thrombocytopenia.
TLDR
Fibrinogen concentrate can match the effect of PT on MCF in thrombocytopenia and should be evaluated in clinical trials.
Correlation of plasma coagulation tests and fibrinogenClauss with rotational thromboelastometry parameters and prediction of bleeding in dogs
TLDR
The MCFFIBTEM can be used to evaluate the effect of fibrinogen on hemostasis as an alternative to determination of fibinogenClauss and is strongly correlated with PT and aPTT, respectively.
Impact of changes in haematocrit level and platelet count on thromboelastometry parameters.
TLDR
The results suggest that readings of thromboelastometry parameters need to be adjusted by Hct and PLT to avoid potential confounding and miss-interpretations in clinical practice.
In vitro thromboelastometric evaluation of the efficacy of frozen platelet transfusion.
TLDR
The ROTEM analysis assessment indicates a dual effect in frozen platelet transfusion: it produces a hypercoagulable state (shortening of CT), and a second, more predominant effect of frozen platelets' functionality impairment compared with fresh platelets (shorter MCF/MCE and longer CFT).
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 38 REFERENCES
The Effects of Platelet Count on Clot Retraction and Tissue Plasminogen Activator-Induced Fibrinolysis on Thrombelastography
TLDR
It is shown that the decrease in amplitude at 30 and 60 min can be due to Platelet-mediated clot retraction and can be attenuated by sample pretreatment with abciximab, which interrupts platelet-fibrin(ogen) binding.
Assessing platelet and fibrinogen contribution to clot strength using modified thromboelastography in pregnant women.
TLDR
Modified thromboelastography using ReoPro in healthy parturients can be used to determine the contribution of fibrinogen and platelets to blood clot strength and may further improve the use of throm boleastography in detecting and treating coagulation defects.
Evaluation of the Contribution of Platelets to Clot Strength by Thromboelastography in Rabbits: The Role of Tissue Factor and Cytochalasin D
TLDR
Rabbits may serve as a model of hemostasis that closely approximates human situations to mechanistically determine the etiology of coagulopathy, and the contribution of platelet function to total clot strength is similar to that observed in humans.
Monitoring platelet glycoprotein IIb/IIIa-fibrin interaction with tissue factor-activated thromboelastography.
Computerized thromboelastography (TEG) was used to study platelet glycoprotein IIb/IIIa function, characterize the consequences of the interaction between polymerizing fibrin and activated platelets,
The effect of fibrinogen concentrate on thrombocytopenia
TLDR
These data show for the first time that impaired clot formation during thrombocytopenia improves with administration of fibrinogen concentrate, which results in a slowdown of blood loss and prolonged survival.
The influence of fibrin polymerization and platelet-mediated contractile forces on citrated whole blood thromboelastography profile.
TLDR
The importance of fibrin polymerisation on the kinetics of throm bus formation is confirmed and the close association between the quality of the thrombus and the functional status of platelets is demonstrated.
Improved Clot Formation by Combined Administration of Activated Factor VII (NovoSeven®) and Fibrinogen (Haemocomplettan® P)
TLDR
The onset of fibrin formation and thrombin generation were shortened after rFVIIa addition, butfibrin clot strength was only increased after fibr inogen supplementation, and in vitro clot formation was most improved by using both rF VIIa and fibrInogen in whole blood after CPB.
Use of abciximab-modified thrombelastography in patients undergoing cardiac surgery.
TLDR
It is concluded that abciximab-modified TEG may help to discriminate between hypofibrinogenemia and platelet dysfunction as a cause of decreased MA, and be able to permit quantitative assessment of the contribution of fibr inogen to clot strength.
Dextran and hydroxyethyl starch interfere with fibrinogen assays.
TLDR
The measured fibrinogen concentrations of patients receiving either dextran or hydroxyethyl starch (HES) were significantly higher than those predicted by the dilutional effects, which suggested that the presence of artificial colloids might interfere with the indirect fibr inogen assay used in the study.
Different effects of abciximab and cytochalasin D on clot strength in thrombelastography
TLDR
In contrast to individual administration of abciximab or cytochalasin D, a combination of both compounds eliminates the platelet‐specific effect on MA of TEG tracings.
...
1
2
3
4
...