ArticleJournal of clinical medicine2020
Sufficient Thrombin Generation Despite 95% Hemodilution: An In Vitro Experimental Study.
Article in Journal of clinical medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 21 citations in OpenAlex.
- ECMO decannulation is associated with dynamic changes in coagulation profiles: an exploratory, nested cohort study.BMC anesthesiology · 2026Observational
- The influence of rotational thromboelastometry (ROTEM) on operating room and intensive care transfusion practices in major trauma bleeding: a prospective cohort study with historical control.Perioperative medicine (London, England) · 2025Article
- Altered thrombin generation with prothrombin complex concentrate is not detected by viscoelastic testing: an in vitro study.British journal of anaesthesia · 2025Article
- [Update on point-of-care-based coagulation treatment : Systems, reagents, device-specific treatment algorithms].Die Anaesthesiologie · 2024Review
- Comparison of Two Viscoelastic Testing Devices in a Parturient Population.Journal of clinical medicine · 2024Article
- Engineering a Two-Component Hemostat for the Treatment of Internal Bleeding through Wound-Targeted Crosslinking.Advanced healthcare materials · 2023Article
- [The chapters "Stop the bleed-prehospital" and "Coagulation management and volume therapy (emergency departement)" in the new S3 guideline "Polytrauma/severe injury treatment"].Notfall & rettungsmedizin · 2023Review
- Effects of Hemodilution on Clot Waveform Analysis Parameters, Clotting Factors, and Thrombin Generation Assays in a Dilutional Model Based on Analysis of 11 Healthy Male Blood Donors.Medical science monitor : international medical journal of experimental and clinical research · 2022Article
- Management of Coagulopathy in Bleeding Patients.Journal of clinical medicine · 2021Review
- Emergency Blood Transfusion for Trauma and Perioperative Resuscitation: Standard of Care.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2021Review
- Article
- Effect of Goal-Directed Crystalloid versus Colloid Administration on Perioperative Hemostasis in Partial Hepatectomy: A Randomized, Controlled Trial.Journal of clinical medicine · 2021Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Guidelines for the treatment of severe bleeding comprise viscoelastic-test-guided use of coagulation factor concentrates as part of their recommendations. The aim of this study is to investigate the effects of substituting fibrinogen, prothrombin complex concentrate, and a combination of both on conventional coagulation tests, viscoelastic test results, and thrombin generation. Blood was drawn from seven healthy volunteers to obtain platelet-free plasma, which later was diluted by replacing 40%, 60%, 80%, 90%, 95%, and 99% with a crystalloid solution. The diluted samples were spiked with fibrinogen concentrate, prothrombin complex concentrate, a combination of both, or a corresponding amount of crystalloid solution. Up to a dilution level of 95%, viscoelastically determined clotting time was significantly shorter in the group substituted with fibrinogen only in comparison with the additional use of prothrombin complex concentrate. Clot firmness and endogenous thrombin potential remained at relatively stable values up to a dilution level of 95% with the substitution of fibrinogen but not prothrombin complex concentrate. Substitution of prothrombin complex concentrate led to an excessive overshoot of thrombin generation. The results of our study question currently propagated treatment algorithms for bleeding patients that include the use of prothrombin complex concentrate for patients without former intake of oral anticoagulants. Even in severely bleeding patients, thrombin generation might be sufficient to achieve adequate hemostasis.
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