Functional Fibrinogen Assay Indicates That Fibrinogen is Critical in Correcting Abnormal Clot Strength Following Trauma

BACKGROUND Thrombelastography (TEG) is emerging as the standard in the management of acute coagulopathies in injured patients. While TEG is sensitive in detecting abnormalities in clot strength, one short-coming is differentiating between fibrinogen and platelet contributions to clot integrity. Current American algorithms suggest platelet transfusion, while European guidelines suggest fibrinogen concentrates for correcting low clot strength. Therefore, we hypothesized that a TEG-based functional fibrinogen assay would assess the contribution of fibrinogen and platelets to clot strength, and provide insight to transfusion priorities.