The place of fibrinogen concentrates in the management of perioperative bleeding: A position paper from the Francophone Working Group on Perioperative Haemostasis (GIHP)

Publication date: Available online 13 April 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Charles Marc Samama, Brigitte Ickx, Yves Ozier, Annick Steib, Sophie Susen, Anne GodierAbstractThe consumption of fibrinogen concentrates has been increasing steadily for several years in surgery, trauma and obstetrics. However, data from the literature are conflicting. The French Working Group on Perioperative Haemostasis (GIHP) proposes a position paper based on a narrative review of the literature, and addresses the following questions: What is the exact role of fibrinogen in haemostasis? Which rational support for the use of perioperative fibrinogen? Which thrombotic risk? What are the most recent professional recommendations on the use of fibrinogen concentrates? Then, evidence-based recommendations are proposed: 1) it is suggested not to administer prophylactic FC to prevent haemorrhage; 2) it is suggested not to use FC alone. Haemostatic treatment must be comprehensive, include other haemostatic treatments and must be limited in cases of severe active haemorrhage; 3) the GIHP suggests urgent measurement of fibrinogen plasma concentration in a biology laboratory or functional fibrinogen by viscoelastic methods. The choice between the two methods must be guided by the time to receive the results from a certified organisation with, in particular, authorisation to perform delocalised biologic examinations; 4) it is suggested not to administer FC when the fibrinogen c...
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research