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Fibrinogen level deteriorates before other routine coagulation parameters and massive transfusion in the early phase of severe trauma : a retrospective observational study

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Title: Fibrinogen level deteriorates before other routine coagulation parameters and massive transfusion in the early phase of severe trauma : a retrospective observational study
Authors: Hayakawa, Mineji Browse this author →KAKEN DB
Gando, Satoshi Browse this author →KAKEN DB
Ono, Yuichi Browse this author
Wada, Takeshi Browse this author
Yanagida, Yuichiro Browse this author
Sawamura, Atsushi Browse this author →KAKEN DB
Keywords: disseminated intravascular coagulation
fibrinolysis
fibrinogenolysis
coagulopathy
bleeding
Issue Date: Feb-2015
Publisher: Thieme
Journal Title: Seminars in thrombosis and hemostasis
Volume: 41
Issue: 01
Start Page: 35
End Page: 42
Publisher DOI: 10.1055/s-0034-1398379
PMID: 25590522
Abstract: In trauma, hemostatic functions should be maintained appropriately to prevent massive bleeding. This study elucidated the time-dependent changes in platelet count and coagulation variables, and the effects of disseminated intravascular coagulation (DIC) on these changes during the early phase of trauma. Trauma patients with an injury severity score ≥16 were enrolled. The critical levels of platelet count and coagulation variables were defined according to recent trauma guidelines. Massive transfusion was defined as >10 units red cell concentrate. The time from arrival at the emergency department to reaching the critical levels and meeting the criteria for massive transfusion were evaluated. Eighty trauma patients were enrolled; 35 were diagnosed with DIC on arrival. Among all patients, fibrinogen levels reached the critical level earliest among routine coagulation parameters; other routine coagulation parameters deteriorated after the patients met the criteria for massive transfusion. Routine coagulation parameters reached their critical levels earlier in DIC patients than patients without DIC. Massive transfusion was performed more frequently in DIC patients, who met the criteria earlier. During the early phase of trauma, fibrinogen levels deteriorate earlier than other routine coagulation parameters, especially in DIC patients.
Type: article (author version)
URI: http://hdl.handle.net/2115/60618
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 早川 峰司

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