Fibrinogen function after severe burn injury

Background: Evidence regarding hypercoagulability in the first week after burn trauma is growing. This hypercoagulable state may partly be caused by increased fibrinogen levels. Rotational thrombelastometry offers a test which measures functional fibrinogen (FIBTEM (R)). To test the hypothesis that in patients with severe burn injury fibrinogen function changes over time, we simultaneously measured FIBTEM (R) and fibrinogen concentration early after burn trauma. Methods: After Ethics Committee approval consecutive patients with severe burn trauma admitted to the burn intensive care unit of the General Hospital of Vienna were included in the study. Blood examinations were done immediately and 12, 24 and 48 h after admission. At each time point fibrinogen level (Clauss) and 4 commercially available ROTEM (R) tests were performed. Results: 20 consecutive patients were included in the study. Fibrinogen level and FIBTEM (R) MCF were within the reference range until 24 h after burn trauma but increased significantly 48 h after trauma. There was a significant correlation between FIBTEM (R) MCF and fibrinogen level (R = 0.714, p < 0.001). Conclusion: The results of this prospective observational clinical study show that fibrinogen function changes early after burn trauma and can be visualized by ROTEM (R) with the fibrinogen-sensitive FIBTEM (R) test. (C) 2010 Elsevier Ltd and ISBI. All rights reserved.