Effekte der exogenen Fibrinogensubstitution auf die endogene Fibrinogensynthese im Tiermodell Schwein bei dilutions- und traumainduzierter Koagulopathie und Hypothermie

Fibrinogen substitution is an established therapeutic element in the treatment of patients with fulminate haemorrhage and hypofibrinogenemia in trauma-induced coagulopathy. Although data from various studies and pharmacovigilance data indicate that the thrombogenic potential of fibrinogen substitution is low, there is little data on fibrinogen metabolism after exogenous fibrinogen concentrate therapy. In this study, the possible influence of exogenous fibrinogen substitution on endogenous fibrinogen synthesis in a 24-hour trauma model was investigated. For this purpose fibrinogen or placebo was substituted (100 mg / kg) on two groups of 12 male pigs with massive coagulopathy after blunt liver trauma and hypothermia. In both groups, fibrinogen concentration, global coagulation parameters, thromboelastometric data and expression of fibrinogen RNA by qRT-PCR were determined. Significant differences in fibrinogen concentration and coagulation parameters between the two groups following the sustitution were finally no longer detectable. The highest fibrinogen concentrations in both groups were messured after 24 hours. In particular, the results of the PCR analysis show that comparable fibrinogen expression occurred in both groups. However, total blood loss was significantly lower in the fibrinogen group. There were no thrombembolic events in any group. The substitution of human fibrinogen had no effect on the fibrinogen expression in this porcine model