D. Fries, A. Krismer, A. Klingler, W. Streif, G. Klima, V. Wenzel, T

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Presentation transcript:

Effect of fibrinogen on reversal of dilutional coagulopathy: a porcine model D. Fries, A. Krismer, A. Klingler, W. Streif, G. Klima, V. Wenzel, T. Haas, P. Innerhofer British Journal of Anaesthesia Volume 95, Issue 2, Pages 172-177 (August 2005) DOI: 10.1093/bja/aei160 Copyright © 2005 British Journal of Anaesthesia Terms and Conditions

Fig 1 Thrombelastographic amplitude showing the dynamics of development of the clot (CT and CFT) and the clot firmness (MCF). British Journal of Anaesthesia 2005 95, 172-177DOI: (10.1093/bja/aei160) Copyright © 2005 British Journal of Anaesthesia Terms and Conditions

Fig 2 (a) ROTEM© analysis: CT, clotting time, (b) ROTEM© analysis: CFT, clot formation time, (c) ROTEM© analysis: MCF, maximal clot firmness and (d) ROTEM© analysis: alpha angle, at: baseline (1); after blood removal (2); after colloid administration (3); after substitution of fibrinogen or saline (4); as well as at the end of the observation period (5), in the animals treated with placebo (Gel) or fibrinogen concentrate (Fib). *Statistically significant differences between the fibrinogen group and the saline group with a P-value <0.05. British Journal of Anaesthesia 2005 95, 172-177DOI: (10.1093/bja/aei160) Copyright © 2005 British Journal of Anaesthesia Terms and Conditions

Fig 3 Electron microscopy scan of a 2000× magnified blood clot in non-diluted state: dense, branched, and meshed reticular fibrin network. British Journal of Anaesthesia 2005 95, 172-177DOI: (10.1093/bja/aei160) Copyright © 2005 British Journal of Anaesthesia Terms and Conditions

Fig 4 Electron microscopy scan of a 2000× magnified blood clot following approximately 65% haemodilution with gelatin: clearly rarified fibrin network. British Journal of Anaesthesia 2005 95, 172-177DOI: (10.1093/bja/aei160) Copyright © 2005 British Journal of Anaesthesia Terms and Conditions

Fig 5 Electron microscopy scan of a 2000× magnified blood clot following administration of fibrinogen concentration to compensate for dilutional coagulopathy: in comparison with Figure 4 the fibrin network is again markedly compact. Because of the concomitant anaemia caused by 66% haemodilution, the clot shows only a few erythrocytes. British Journal of Anaesthesia 2005 95, 172-177DOI: (10.1093/bja/aei160) Copyright © 2005 British Journal of Anaesthesia Terms and Conditions