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Hochdosierte Fibrinogengabe zur Akuttherapie von Gerinnungsstörungen bei perioperativer Massivtransfusion

High dose fibrinogen administration for acute therapy of coagulopathy during massive perioperative transfusion

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Zusammenfassung

Im Rahmen einer akuten, schweren perioperativen Blutung kann es zu einer Kombination von Verlust, Verbrauch und Dilution von Gerinnungsfaktoren und Thrombozyten kommen. Diagnostik und Therapie der Gerinnungsstörung sollten möglichst früh erfolgen. Wir berichten über 2 Fälle von akuten Koagulopathien im Rahmen schwerer perioperativer Blutungen mit Massivtransfusion, die rasch durch die hochdosierte Gabe von Fibrinogen therapiert werden konnten. Diagnostik und Therapiekontrolle der Gerinnungsstörungen erfolgten über die Thrombelastographie.

Abstract

During acute and severe perioperative bleeding a coagulopathy due to depletion, consumption and dilution of clotting factors and thrombocytes may occur. Diagnosis and therapy of such a coagulopathy should take place immediately. We report two cases of acute coagulopathy during perioperative bleeding and massive transfusion, which were treated successfully by administration of high dose fibrinogen concentrate. Diagnosis and treatment control were performed by thrombelastography.

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Literatur

  1. Chitolie A, Mackie IJ, Grant D et al. (1994) Inaccuracy of the „derived“ fibrinogen measurement. Blood Coagul Fibrinolysis 5:955–957

    CAS  PubMed  Google Scholar 

  2. Fries D, Innerhofer P, Klingler A et al. (2002) The effect of the combined administration of colloids and lactated Ringer’s solution on the coagulation system: an in vitro study using thrombelastograph coagulation analysis (ROTEG). Anesth Analg 94:1280–1287

    Article  CAS  PubMed  Google Scholar 

  3. Fries D, Krismer A, Schobersberger A et al. (2003) The effect of fibrinogen on dilutional coagulopathy — A porcine model. Intensive Care Med 29 [Suppl 1]:527

  4. Hardy JF, Moerloose P, Samama M and members of the Groupe d’Interet en Hemostase Perioperatoire (2004) Massive transfusion and coagulopathy: pathophysiology and implications for clinical management. Can J Anesth 51:293–310

    Google Scholar 

  5. Hiippala ST (1995) Dextran and hydroxyethyl starch interfere with fibrinogen assays. Blood Coagul Fibrinolysis 6:743–746

    PubMed  Google Scholar 

  6. Hiippala ST, Myllyla GJ, Vahtera EM (1995) Hemostatic factors and replacement of major blood loss with plasma-poor red cell concentrates. Anesth Analg 81:360–365

    Article  PubMed  Google Scholar 

  7. Innerhofer P, Fries D, Margreiter J et al. (2002) The effect of perioperatively administered colloids and crystalloids on primary hemostasis and clot formation. Anesth Analg 95:858–865

    Article  PubMed  Google Scholar 

  8. MacLeod J, Lynn M, McKenney MG et al. (2003) Early coagulopathy predicts mortality in trauma. J Trauma 55:39–44

    PubMed  Google Scholar 

  9. Parameswaran R, Dickson JP, Lord S de et al. (2000) Spontaneous intracranial bleeding in two patients with congenital afibrinogenaemia and the role of replacement therapy. Haemophilia 6:705–708

    Article  CAS  PubMed  Google Scholar 

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Interessenkonflikt:

Der korrespondierende Autor weist auf eine Verbindung mit folgender Firma/Firmen hin: Herr PD Dr. B. Heindl hat nach Einreichung des Manuskriptes mehrere bezahlte wissenschaftliche Vorträge für die Firma ZLB Behring gehalten.

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Authors and Affiliations

  1. Klinik für Anaesthesiologie, Ludwig Maximilians Universität, München

    B. Heindl & C. DeLorenzo

  2. Abteilung für Hämostaseologie und Transfusionsmedizin, Ludwig Maximilians Universität, München

    M. Spannagl

  3. Klinik für Anaesthesiologie, Ludwig Maximilians Universität, Nussbaumstr. 20, 80336, München

    B. Heindl

Authors
  1. B. Heindl
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  2. C. DeLorenzo
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  3. M. Spannagl
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Correspondence to B. Heindl.

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Heindl, B., DeLorenzo, C. & Spannagl, M. Hochdosierte Fibrinogengabe zur Akuttherapie von Gerinnungsstörungen bei perioperativer Massivtransfusion. Anaesthesist 54, 787–790 (2005). https://doi.org/10.1007/s00101-005-0865-7

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  • DOI: https://doi.org/10.1007/s00101-005-0865-7

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