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2016 | OriginalPaper | Buchkapitel

4. Fibrinogen (FI)

verfasst von : Ao. Univ. Prof. Dr. Dietmar Fries, MA rer. nat. Mirjam Bachler, Dr. med. Martin Hermann

Erschienen in: Transfusionsassoziierte Pharmakotherapie

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Das Hauptsubstrat der Gerinnung ist Fibrinogen (FI). Bei akuter Blutung ist es zumeist der erste Gerinnungsfaktor, der kritische Grenzwerte erreicht (150–200 mg/dl). FI kann hervorragend mittels point-of-care-tauglicher viskoelastischer Methoden (Thrombelstographie oder Thrombelastometrie) monitiert werden. Die Substitution kann mittels Frischplasma, Cryopräzipitat oder Fibrinogenkonzentrat erfolgen. Frischplasma ist nicht besonders effektiv, mit einer erhöhten Morbidität, insbesondere bei kritisch Kranken, sowie mit Volumenbelastung assoziiert. Cryopräzipitat wird in einigen europäischen Ländern nicht angeboten. Die Gabe von Fibrinogenkonzentrat wird in verschiedenen Leitlinien empfohlen. Als Akut-Phase-Protein kann FI physiologischerweise bei Entzündungsprozessen, schweren Verletzungen sowie nach großen Operationen in kurzer Zeit auf über 1000 mg/dl ansteigen; wobei hier Fibrinogenspaltprodukte anti-inflammatorische und sogar antibakterielle Eigenschaften haben.
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Metadaten
Titel
Fibrinogen (FI)
verfasst von
Ao. Univ. Prof. Dr. Dietmar Fries
MA rer. nat. Mirjam Bachler
Dr. med. Martin Hermann
Copyright-Jahr
2016
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-47258-3_4

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