FIBRINOGEN LEVELS AND BLOOD TRANSFUSION VOLUMES IN PATIENTS REQUIRING MASSIVE TRANSFUSION

• Published in: Japanese Journal of Transfusion and Cell Therapy Vol. 59; no. 1; pp. 38 - 42
• Main Authors: Anan, Masahiro, Okubo, Mitsuo, Ohki, Hiroko, Imai, Atsuko, Noro, Mitsue, Mori, Eriko, Maeda, Hiroo
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society of Transfusion Medicine and Cell Therapy 2013
• Subjects: coagulopathy; fibrinogen concentrate; hypofibrinogenemia; massive hemorrhage; massive transfusion
• ISSN: 1881-3011; 1883-0625
• DOI: 10.3925/jjtc.59.38

Introduction: Fibrinogen concentrate or cryoprecipitate is currently administered to patients with acquired fibrinogen (Fib) deficiency associated with conditions such as hemorrhage, and the use of these products reportedly reduces not only blood loss but also transfusion requirements of red cells concentrate (RCC) and fresh frozen plasma (FFP). In Japan, however, only FFP is available for use with such patients. Here, we investigated Fib levels and blood transfusion volumes in patients requiring massive transfusion (MT). Subjects and Methods: Subjects comprised patients who received ≥10 units of red blood cells in 1 calendar day at our institution between September 2010 and August 2011. Transfusion volumes of blood products administered on the day of MT and minimum Fib levels on the day before MT were assessed. Results: Total volumes of RCC and FFP transfused to patients during the study period were 16,146 units (to 5,125 patients) and 10,120 units (to 1,547 patients), respectively. RCC totaling 3,294 units (20.4% of total transfusion volume) was administered to 188 patients (3.7%), and FFP totaling 3,092 units (30.6%) was administered to 177 patients (11.4%). RCC and FFP transfusions in MT patients with Fib <150mg/dl totaled 1,840 units (11% of RCC total transfusion volume) and 1,918 units (19% of total transfusion volume), respectively. Discussion: Large volumes of FFP are required if selected as a treatment for acquired hypofibrinogenemia, leading to a risk of pulmonary edema. For patients potentially requiring MT, Fib levels should be measured and subsequent consideration given to administration of Fib preparations for patients with severe deficiency, in an effort to help reduce RCC and FFP usage.