Dept. of Anesthesiology, General Intensive Care and Pain Control, Medical University Of Vienna, Austria.
Burns. 2012 Feb;38(1):77-82. doi: 10.1016/j.burns.2010.12.004. Epub 2011 Nov 23.
Evidence regarding hypercoagulability in the first week after burn trauma is growing. This hypercoagulable state may partly be caused by increased fibrinogen levels. Rotational thrombelastometry offers a test which measures functional fibrinogen (FIBTEM(®)). To test the hypothesis that in patients with severe burn injury fibrinogen function changes over time, we simultaneously measured FIBTEM(®) and fibrinogen concentration early after burn trauma.
After Ethics Committee approval consecutive patients with severe burn trauma admitted to the burn intensive care unit of the General Hospital of Vienna were included in the study. Blood examinations were done immediately and 12, 24 and 48 h after admission. At each time point fibrinogen level (Clauss) and 4 commercially available ROTEM(®) tests were performed.
20 consecutive patients were included in the study. Fibrinogen level and FIBTEM(®) MCF were within the reference range until 24 h after burn trauma but increased significantly 48 h after trauma. There was a significant correlation between FIBTEM(®) MCF and fibrinogen level (R=0.714, p<0.001).
The results of this prospective observational clinical study show that fibrinogen function changes early after burn trauma and can be visualized by ROTEM(®) with the fibrinogen-sensitive FIBTEM(®) test.
有关烧伤创伤后第一周高凝状态的证据越来越多。这种高凝状态可能部分是由纤维蛋白原水平升高引起的。旋转血栓弹性仪提供了一种测试，可测量功能性纤维蛋白原（FIBTEM®）。为了验证严重烧伤患者的纤维蛋白原功能随时间变化的假设，我们在烧伤后早期同时测量了 FIBTEM®和纤维蛋白原浓度。
在获得伦理委员会批准后，连续纳入维也纳总医院烧伤重症监护病房收治的严重烧伤患者进行研究。入院后立即进行血液检查，并在 12、24 和 48 小时后进行检查。在每个时间点均检测纤维蛋白原水平（Clauss）和 4 种市售的 ROTEM®检测。
本研究共纳入 20 例连续患者。纤维蛋白原水平和 FIBTEM® MCF 在烧伤后 24 小时内均处于参考范围内，但在创伤后 48 小时显著增加。FIBTEM® MCF 与纤维蛋白原水平之间存在显著相关性（R=0.714，p<0.001）。
这项前瞻性观察性临床研究的结果表明，纤维蛋白原功能在烧伤后早期发生变化，可通过纤维蛋白原敏感的 FIBTEM®检测 ROTEM®可视化。
