Fibrinogen dosing recommendations in published algorithms
| Reference . | Clinical setting . | Trigger for administering fibrinogen concentrate . | Fibrinogen dose . |
|---|---|---|---|
| 66 | Cardiac surgery | Using conventional laboratory measures: <200 mg/dL (<2 g/L) | 25 mg/kg |
| <150 mg/dL (<1.5 g/L) | 50 mg/kg | ||
| Using POC: EXTEM A10 <40 mm and FIBTEM A10 <8 mm | 25 mg/kg | ||
| EXTEM A10 <40 mm and FIBTEM A10 <6 mm | 50 mg/kg | ||
| EXTEM A10 <40 mm and FIBTEM A10 <4 mm | 75 mg/kg | ||
| EXTEM A10 <30 mm and FIBTEM A10 <4 mm | 75 mg/kg + 2 PC + 0.4 µg/kg DDAVP | ||
| 74 | Trauma | FIBTEM CA10 <7 mm | 2-6 g |
| EXTEM CA10 <30 mm | 6-8 g and PCC 20-30 U/kg BW | ||
| 100 | Liver transplantation | Massive diffuse bleeding and EXTEM MCF <25 mm | Fibrinogen concentrate,* PC and PCC |
| EXTEM MCF <35 mm and FIBTEM MCF <8 mm | 25 mg/kg (or cryoprecipitate); 50 mg/kg if FIBTEM MCF <4 mm | ||
| EXTEM MCF <45 mm and FIBTEM MCF <8 mm | 25 mg/kg (or cryoprecipitate); 50 mg/kg if FIBTEM MCF <4 mm |
| Reference . | Clinical setting . | Trigger for administering fibrinogen concentrate . | Fibrinogen dose . |
|---|---|---|---|
| 66 | Cardiac surgery | Using conventional laboratory measures: <200 mg/dL (<2 g/L) | 25 mg/kg |
| <150 mg/dL (<1.5 g/L) | 50 mg/kg | ||
| Using POC: EXTEM A10 <40 mm and FIBTEM A10 <8 mm | 25 mg/kg | ||
| EXTEM A10 <40 mm and FIBTEM A10 <6 mm | 50 mg/kg | ||
| EXTEM A10 <40 mm and FIBTEM A10 <4 mm | 75 mg/kg | ||
| EXTEM A10 <30 mm and FIBTEM A10 <4 mm | 75 mg/kg + 2 PC + 0.4 µg/kg DDAVP | ||
| 74 | Trauma | FIBTEM CA10 <7 mm | 2-6 g |
| EXTEM CA10 <30 mm | 6-8 g and PCC 20-30 U/kg BW | ||
| 100 | Liver transplantation | Massive diffuse bleeding and EXTEM MCF <25 mm | Fibrinogen concentrate,* PC and PCC |
| EXTEM MCF <35 mm and FIBTEM MCF <8 mm | 25 mg/kg (or cryoprecipitate); 50 mg/kg if FIBTEM MCF <4 mm | ||
| EXTEM MCF <45 mm and FIBTEM MCF <8 mm | 25 mg/kg (or cryoprecipitate); 50 mg/kg if FIBTEM MCF <4 mm |
A10, clot amplitude on ROTEM after 10 minutes; BW, bodyweight; CA, clot amplitude; DDAVP, 1-desamino-8-d-arginin-vasopressin; EXTEM, tissue factor-activated clotting test based on ROTEM; FIBTEM, EXTEM-based clotting assay with cytochalasin for evaluating fibrinogen levels; PC, platelet concentrate; PCC, prothrombin complex concentrate; POC, point of care.
Dose not specified.