Fibrinogen

Aka: Fibrinogen

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II. Mechanism

  1. Acute phase reactant
  2. Clotting Cascade component
    1. Marker of adequate Hemostasis
    2. Marker in Trauma of Massive Hemorrhage
      1. Lower Fibrinogen level correlates with increased blood loss, need for transfusion, and worse outcomes
    3. In Cirrhosis, Emergency Procedures have Fibrinogen levels thresholds
      1. Low risk Emergency Procedures in Cirrhosis should have a Fibrinogen Level >100-120
      2. High risk Emergency Procedures in Cirrhosis should have a Fibrinogen Level >150
      3. Fibrinogen may be increased with 1 pack of Cryoprecipitate (2 packs if weight >80 kg)
      4. Patel (2019) J Vasc Interv Radiol 30(8):1168-84 +PMID: 31229333 [PubMed]

III. Labs: Normal

  1. Normal: 200-400 mg/dl (2 to 4 g/L)

IV. Causes: Increased Fibrinogen

  1. Tissue inflammation or damage
  2. Acute infection
  3. Myocardial Infarction
  4. Medications
    1. Oral Contraceptives
  5. Pregnancy

V. Causes: Decreased Fibrinogen

  1. Disseminated Intravascular Coagulation
  2. Primary or Secondary Fibrinolysis
  3. Liver disease
  4. Hereditary afibrinogenemia or Hypofibrinogenemia
  5. Cachexia
  6. Massive Hemorrhage (Trauma)

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