Cited by 213Blood transfusion and managementTrauma, Hemostasis, Coagulopathy, ResuscitationMaternal and fetal healthcare

Introduction of an algorithm for ROTEM ‐guided fibrinogen concentrate administration in major obstetric haemorrhage

Mallaiah, S., Barclay, P., Harrod, I., Chevannes, C., Bhalla, A.·2015·Anaesthesia

Abstract

We compared blood component requirements during major obstetric haemorrhage, following the introduction of fibrinogen concentrate. A prospective study of transfusion requirements and patient outcomes was performed for 12 months to evaluate the major obstetric haemorrhage pathway using shock packs (Shock Pack phase). The study was repeated after the pathway was amended to include fibrinogen concentrate (Fibrinogen phase). The median (IQR [range]) number of blood components given was 8.0 (3.0-14.5 [0-32]) during the Shock Pack phase, and 3.0 (2.0-5.0 [0-26]) during the Fibrinogen phase (p = 0.0004). The median (IQR [range]) quantity of fibrinogen administered was significantly greater in the Shock Pack phase, 3.2 (0-7.1 [0-20.4]) g, than in the Fibrinogen phase, 0 (0-3.0 [0-12.4]) g, p = 0.0005. Four (9.5%) of 42 patients in the Shock Pack phase developed transfusion associated circulatory overload compared with none of 51 patients in the Fibrinogen phase (p = 0.038). Fibrinogen concentrate allows prompt correction of coagulation deficits associated with major obstetric haemorrhage, reducing the requirement for blood component therapy and the attendant risks of complications.

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Crossref · 10.1111/anae.12859

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Authors
Mallaiah, S., Barclay, P., Harrod, I., Chevannes, C., & Bhalla, A.
Affiliations
Liverpool Women's Hospital (GB)
Corresponding author
Mallaiah, S.
Venue
Anaesthesia
Publisher
Wiley
Published
2014-10-07
Volume
70
Issue
2
Pages
166-175
ISSN
  • 0003-2409 (ISSN-L)
  • 1365-2044
OpenAlex
W1970331972
Cited by
213
References
34
Citations by year
2026: 9 · 2025: 16 · 2024: 13 · 2023: 17 · 2022: 22 · 2021: 20 · 2020: 16 · 2019: 21 · 2018: 11 · 2017: 21 · 2016: 24 · 2015: 19 · 2014: 2 · 2013: 2
FWCI
15.44
Type
journal article
Language
en
Open access
closed
Locations
  • Anaesthesia (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • CSL Behring
  • University of Liverpool
Topics
  • Health Sciences › Medicine › Biochemistry › Blood transfusion and management
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
Keywords
major obstetric haemorrhage, fibrinogen concentrate, rotational thromboelastometry, coagulopathy, transfusion-associated circulatory overload, obstetric transfusion, coagulation therapy
MeSH terms
Algorithms, Blood Coagulation, Blood Transfusion, Female, Fibrinogen, Postpartum Hemorrhage, Hemostatics, Humans, Pregnancy, Prospective Studies, Thrombelastography, Treatment Outcome

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