II. Indications
-
Massive Hemorrhage (e.g. Trauma, cardiac surgery, Postpartum Hemorrhage)
- Alternative to Cryoprecipitate
- Trauma or Gastrointestinal Bleeding
- Transfuse Fibrinogen Concentrate (or Cryoprecipitate) if Fibrinogen <150 mg/dl
- Postpartum Hemorrhage
- Transfuse Fibrinogen Concentrate (or Cryoprecipitate) if Fibrinogen <200 mg/dl
III. Efficacy: Massive Hemorrhage
- Noninferior to cryprecipitate in cardiac surgery related bleeding
- In contrast to Cryoprecipitate, Fibrinogen has several advantages
- Consistent dosing (variable with Cryoprecipitate)
- Rapidly reconstituted (no thawing needed)
- Longer shelf life (24 hours instead of 6 hours)
- No major transfusion adverse effects
IV. References
- Petrosoniak and Swaminathan in Swadron (January, 2023) EM:RAP