纤维蛋白原浓缩物在创伤相关出血管理中的应用：系统评价和荟萃分析。
The use of fibrinogen concentrate for the management of trauma-related bleeding: a systematic review and meta-analysis.
机构信息
Italian National Blood Centre, National Institute of Health, Rome, Italy.
Department of Haematology and Transfusion Medicine, "Carlo Poma" Hospital, Mantua, Italy.
出版信息
Blood Transfus. 2017 Jul;15(4):318-324. doi: 10.2450/2017.0094-17.
Abstract
Haemorrhage following injury is associated with significant morbidity and mortality. The role of fibrinogen concentrate in trauma-induced coagulopathy has been the object of intense research in the last 10 years and has been systematically analysed in this review. A systematic search of the literature identified six retrospective studies and one prospective one, involving 1,650 trauma patients. There were no randomised trials. Meta-analysis showed that fibrinogen concentrate has no effect on overall mortality (risk ratio: 1.07, 95% confidence interval: 0.83-1.38). Although the meta-analytic pooling of the current literature evidence suggests no beneficial effect of fibrinogen concentrate in the setting of severe trauma, the quality of data retrieved was poor and the final results of ongoing randomised trials will help to further elucidate the role of fibrinogen concentrate in traumatic bleeding.
摘要
出血是创伤后常见的并发症，可导致较高的发病率和死亡率。在过去的 10 年中，纤维蛋白原浓缩物在创伤性凝血病中的作用一直是研究的热点，并在本综述中进行了系统分析。系统检索文献共确定了 6 项回顾性研究和 1 项前瞻性研究，涉及 1650 例创伤患者。但没有随机试验。荟萃分析显示纤维蛋白原浓缩物对总体死亡率没有影响（风险比：1.07，95%置信区间：0.83-1.38）。尽管当前文献证据的荟萃分析表明，在严重创伤的情况下，纤维蛋白原浓缩物没有有益的效果，但检索到的数据质量较差，正在进行的随机试验的最终结果将有助于进一步阐明纤维蛋白原浓缩物在创伤性出血中的作用。
相似文献
1
The use of fibrinogen concentrate for the management of trauma-related bleeding: a systematic review and meta-analysis.
Blood Transfus. 2017 Jul;15(4):318-324. doi: 10.2450/2017.0094-17.
2
Effect of early administration of fibrinogen replacement therapy in traumatic haemorrhage: a systematic review and meta-analysis of randomised controlled trials with narrative synthesis of observational studies.
Crit Care. 2025 Jan 28;29(1):49. doi: 10.1186/s13054-025-05269-y.
3
Blood transfusion strategies for major bleeding in trauma.
Cochrane Database Syst Rev. 2025 Apr 24;4(4):CD012635. doi: 10.1002/14651858.CD012635.pub2.
4
Ablative and non-surgical therapies for early and very early hepatocellular carcinoma: a systematic review and network meta-analysis.
Health Technol Assess. 2023 Dec;27(29):1-172. doi: 10.3310/GK5221.
5
The effectiveness and cost-effectiveness of carmustine implants and temozolomide for the treatment of newly diagnosed high-grade glioma: a systematic review and economic evaluation.
Health Technol Assess. 2007 Nov;11(45):iii-iv, ix-221. doi: 10.3310/hta11450.
6
Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis.
Cochrane Database Syst Rev. 2021 Apr 19;4(4):CD011535. doi: 10.1002/14651858.CD011535.pub4.
7
Antifibrinolytic drugs for treating primary postpartum haemorrhage.
Cochrane Database Syst Rev. 2018 Feb 20;2(2):CD012964. doi: 10.1002/14651858.CD012964.
8
Thrombopoietin mimetics for patients with myelodysplastic syndromes.
Cochrane Database Syst Rev. 2017 Sep 30;9(9):CD009883. doi: 10.1002/14651858.CD009883.pub2.
9
Parent-training programmes for improving maternal psychosocial health.
Cochrane Database Syst Rev. 2004(1):CD002020. doi: 10.1002/14651858.CD002020.pub2.
10
Dexrazoxane for preventing or reducing cardiotoxicity in adults and children with cancer receiving anthracyclines.
Cochrane Database Syst Rev. 2022 Sep 27;9(9):CD014638. doi: 10.1002/14651858.CD014638.pub2.
引用本文的文献
1
Platelet recruitment kinetics are impacted by von Willebrand factor quality in hemostatic adjuncts.
Blood Vessel Thromb Hemost. 2025 May 9;2(3):100076. doi: 10.1016/j.bvth.2025.100076. eCollection 2025 Aug.
2
Evaluation of Trauma-Induced Coagulopathy by Systematic Insights Into Pathophysiology and Advances in Emergency Resuscitation.
Cureus. 2025 May 10;17(5):e83839. doi: 10.7759/cureus.83839. eCollection 2025 May.
3
Effect of early administration of fibrinogen replacement therapy in traumatic haemorrhage: a systematic review and meta-analysis of randomised controlled trials with narrative synthesis of observational studies.
Crit Care. 2025 Jan 28;29(1):49. doi: 10.1186/s13054-025-05269-y.
4
Resonant Acoustic Rheometry to Measure Coagulation Kinetics in Hemophilia A and Healthy Plasma: A Novel Viscoelastic Method.
Semin Thromb Hemost. 2023 Mar;49(2):201-208. doi: 10.1055/s-0042-1757896. Epub 2022 Nov 1.
5
Dynamic use of fibrinogen under viscoelastic assessment results in reduced need for plasma and diminished overall transfusion requirements in severe trauma.
J Trauma Acute Care Surg. 2022 Aug 1;93(2):166-175. doi: 10.1097/TA.0000000000003624. Epub 2022 Mar 28.
6
The Pathophysiology and Management of Hemorrhagic Shock in the Polytrauma Patient.
J Clin Med. 2021 Oct 19;10(20):4793. doi: 10.3390/jcm10204793.
7
Protocol for a multicentre, randomised, parallel-control, superiority trial comparing administration of clotting factor concentrates with a standard massive haemorrhage protocol in severely bleeding trauma patients: the FiiRST 2 trial (a 2020 EAST multicentre trial).
BMJ Open. 2021 Sep 3;11(9):e051003. doi: 10.1136/bmjopen-2021-051003.
8
Fibrinogen inhibits microRNA-19b, a novel mechanism for repair of haemorrhagic shock-induced endothelial cell dysfunction.
Blood Transfus. 2021 Sep;19(5):420-427. doi: 10.2450/2021.0361-20. Epub 2021 Jan 27.
9
Whole Blood, Fixed Ratio, or Goal-Directed Blood Component Therapy for the Initial Resuscitation of Severely Hemorrhaging Trauma Patients: A Narrative Review.
J Clin Med. 2021 Jan 17;10(2):320. doi: 10.3390/jcm10020320.
10
Variations and obstacles in the use of coagulation factor concentrates for major trauma bleeding across Europe: outcomes from a European expert meeting.
Eur J Trauma Emerg Surg. 2022 Apr;48(2):763-774. doi: 10.1007/s00068-020-01563-2. Epub 2021 Jan 5.
本文引用的文献
1
Fibrinogen concentrate in surgery.
Blood Transfus. 2017 May;15(3):215-217. doi: 10.2450/2017.0362-16. Epub 2016 Mar 9.
2
Fibrinogen in traumatic haemorrhage: A narrative review.
Injury. 2017 Feb;48(2):230-242. doi: 10.1016/j.injury.2016.12.012. Epub 2016 Dec 26.
3
Hemotherapy algorithm for the management of trauma-induced coagulopathy: the German and European perspective.
Curr Opin Anaesthesiol. 2017 Apr;30(2):257-264. doi: 10.1097/ACO.0000000000000433.
4
Fibrinogen in the initial resuscitation of severe trauma (FiiRST): a randomized feasibility trial.
Br J Anaesth. 2016 Dec;117(6):775-782. doi: 10.1093/bja/aew343.
5
Pilot Randomized trial of Fibrinogen in Trauma Haemorrhage (PRooF-iTH): study protocol for a randomized controlled trial.
Trials. 2016 Jul 19;17(1):327. doi: 10.1186/s13063-016-1439-5.
6
The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition.
Crit Care. 2016 Apr 12;20:100. doi: 10.1186/s13054-016-1265-x.
7
Recommendations for the implementation of a Patient Blood Management programme. Application to elective major orthopaedic surgery in adults.
Blood Transfus. 2016 Jan;14(1):23-65. doi: 10.2450/2015.0172-15. Epub 2015 Dec 15.
8
Coagulopathy and transfusion strategies in trauma. Overwhelmed by literature, supported by weak evidence.
Blood Transfus. 2016 Jan;14(1):3-7. doi: 10.2450/2015.0244-15. Epub 2015 Nov 20.
9
Injectable hemostatic adjuncts in trauma: Fibrinogen and the FIinTIC study.
J Trauma Acute Care Surg. 2015 Jun;78(6 Suppl 1):S76-82. doi: 10.1097/TA.0000000000000632.
10
Fibrinogen concentrate as haemostatic therapy in acquired bleeding disorders: not only a question of dosing strategies and thresholds.
Blood Transfus. 2015 Jan;13(1):159-60. doi: 10.2450/2014.0204-14. Epub 2014 Oct 23.
Zotero 插件