The Thromboelastography: Clinical Significance of Functional Fibrinogen Test

A.Yu. Bulanov1, 2, K.V. Yatsckov1, E.L. Bulanova1,3, N.V. Dobrova1

1 52th Moscow City hospital, Moscow

2 Russian University of Friendship, Moscow

3 First Moscow Medical University, Moscow

For correspondence: Bulanov Andrey Yulievich — Doctor of Medical Science, Head of consultative transfusiology team of 52th Moscow City hospital, Professor of Department of Anesthesiology and Reanimatology of Russian University of Friendship, Moscow; e-mail:

For citation: Bulanov AYu, Yatsckov KV, Bulanova EL, Dobrova NV. The Thromboelastography: Clinical Significance of Functional Fibrinogen Test. Intensive Care Herald. 2017;1:5–11.

The hemostatic system is a frequent subject of interest of critical care. Critical hemostasis has been studied most commonly using thromboelastography. Presented study report the experience in the use of special TEG technology fictional fibrinogen test. As the main working area of FF-test should be marked posthemorrhagic coagulopathy, a situation demanding close attention to the function of the platelets when combined with hyperfibrinogenemia (increase in fibrinogen associated with nonspecific inflammation, gestational hyperofibrinogenemia). A significant difference (more than 2 g/l) between the level of fibrinogen of the plasma is estimated by the method of Claus and FF-test can serve as a marker of dysfibrinogenemia. The clinical importance of the methodology is a predictor of thrombotic and haemorrhagic problems, the diagnostic marker, a reference point for the purpose of transfusion therapy.

Keywords: thromboelastography, functional fibrinogen, bleeding, thrombosis, intensive care

Received: 21.01.2017 


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Hyperfibrinolysis and Blood Clot Retraction on Major Trauma

V.S. Afonchikov, A.V. Miheeva

Saint-Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine, Saint-Petersburg

Saint-Petersburg State University, Saint-Petersburg

For correspondence: Afonchikov Vyacheslav Sergeevich — Chief-anesthesiologist of Saint-Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine; e-mail:

For citation: Afonchikov VS, Miheeva AV. Hyperfibrinolysis and blood clot retraction on major trauma. Intensive Care Herald. 2016;3:47–52.

Hyperfibrinolysis with shock and major trauma is considered today as one of the leading causes of early trauma-induced coagulopathy. At the present time thromboelastography is the main world wide method of assessment of blood fibrinolytic activity. Quantitative evaluation of spontaneous fibrinolytic activity is based on the reduction of the maximum amplitude and the surface area under the curve of thromboelastogram. This approach seems to be not quite correct, as this ignores the retraction of a blood clot. A comparative analysis of the activity of spontaneous fibrinolysis and retraction of a blood clot in the acute period of traumatic disease was performed. The study showed the need to assess the degree of clot retraction for adequate clinical interpretation of the results of thromboelastography.

Methods. The study involved 36 patients with major trauma. Thromboelastography of citrated blood, citrated platelet poor plasma samples and spontaneous fibrinolysis and retraction tests (E.P. Ivanov methodics) were obtained at the time of admission and after 3, 6 and 12 hours.

Results. During the study has revealed significant increase of tromboelastography indicators of fibrinolytic activity in the citrated blood samples and the absence of fibrinolytic activity in samples of platelet poor plasma, at the same time spontaneous fibrinolysis and retraction tests (E.P. Ivanov methodics) demonstrate a significant increase in the index of clot retraction and minimal fibrinolytic activity.

Conclusions. Thromboelastogrphy parameters, used to assess the fibrinolytic activity, are integrally evaluated a combination of two processes: spontaneous fibrinolysis and clot retraction. For adequately assess the thromboelastogrphy parameters we need to assess the clot retraction activity.

Keywords: hyperfibrinolysis, trauma, early trauma-induced coagulopathy, thromboelastography, blood clot retraction

Received: 29.07.2016


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