{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T23:46:10Z","timestamp":1782344770062,"version":"3.54.5"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","funder":[{"DOI":"10.13039\/501100024776","name":"CSL Behring Espa\u00f1a","doi-asserted-by":"crossref","award":["NCT00994045"],"award-info":[{"award-number":["NCT00994045"]}],"id":[{"id":"10.13039\/501100024776","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Thromb Hemost"],"abstract":"<jats:p>In a parallel-assignment, single-blinded study, we measured the detailed coagulation profile of 20 patients randomized to receive infusions of fresh frozen plasma (FFP) or fibrinogen concentrate during surgery associated with major surgical hemorrhage\u2014Extent 4 Thoraco-abdominal Aortic Aneurysm repair. Ten patients received FFP; 10 fibrinogen concentrate, infused to achieve plasma fibrinogen concentration around 1.5\u2009g\/L. There were predefined hemoglobin and ROTEM cut-offs for red cell and platelet administration. Blood samples were taken at up to 12 predefined time points before, during, and after surgery. Measurements included coagulation and anticoagulant factor concentrations, thrombin generation, activated protein C (aPC) concentrations, and thromboelastography. Intraoperative blood loss was between 2,750 and 16,500\u2009mL. During surgery, plasma fibrinogen concentration was slightly lower in the FFP group but maintained or restored to approximately 1.5\u2009g\/L. When blood loss exceeded approximately 4,000\u2009mL, most factor concentrations and conventional tests were superior in the FFP group. Mean (standard deviation) prothrombin time (15.8 [2.3] vs. 26.3 [5.1]) and activated partial thromboplastin time (42.8 [8.6] vs. 60.4 [15.8]) seconds; p\u2009&lt;\u20090.001. Protein C and aPC concentrations trended higher in the FFP group: protein C\u2009=\u200959.7 (18.4) versus 30.0 (10.6)% normal; p\u2009&lt;\u20090.001, aPC\u2009=\u20096.9 (5.5) versus 3.1 (2.3) g\/L; p\u2009=\u20090.001. Differences in peak thrombin generation 2\u2009hours postoperatively in the FFP group did not meet statistical significance: (224.3 [54.8] vs. 133.0 [66.0]) nM; p\u2009=\u20090.004. In this exploratory cohort, both FFP and fibrinogen concentrate administration achieved low-normal plasma fibrinogen concentrations. Although coagulation factor concentrations and thrombin generation were lower in the fibrinogen concentrate group at blood losses above 4,000\u2009mL, this was not associated with worse surgical hemostasis or observed bleeding complications.<\/jats:p>","DOI":"10.1055\/a-2896-8150","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T23:20:58Z","timestamp":1781652058000},"source":"Crossref","is-referenced-by-count":0,"title":["Comparison of the Coagulation Profile Following Treatment of Major Surgical Haemorrhage with Fresh Frozen Plasma or Fibrinogen Concentrate"],"prefix":"10.1055","clinical-trial-number":[{"clinical-trial-number":"nct00994045","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5594-2279","authenticated-orcid":false,"given":"Ian J. B.","family":"Young","sequence":"additional","affiliation":[{"name":"Royal Infirmary of Edinburgh, United Kingdom of Great Britain and Northern Ireland","place":["Edinburgh"],"department":["Department of Anaesthesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neill","family":"Aitken","sequence":"additional","affiliation":[{"name":"Newcastle Upon Tyne Hospitals NHS Foundation Trust, England, United Kingdom of Great Britain and Northern Ireland","place":["Newcastle upon Tyne"],"department":["Department of Anaesthesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Dickson","sequence":"additional","affiliation":[{"name":"The University of Edinburgh, Scotland, United Kingdom of Great Britain and Northern Ireland","place":["Edinburgh"],"department":["Department of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Anderson","sequence":"additional","affiliation":[{"name":"Royal Infirmary of Edinburgh, United Kingdom of Great Britain and Northern Ireland","place":["Edinburgh"],"department":["Department of Clinical and Laboratory Haematology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Morrison","sequence":"additional","affiliation":[{"name":"Royal Infirmary of Edinburgh, United Kingdom of Great Britain and Northern Ireland","place":["Edinburgh"],"department":["Department of Anaesthesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yesim","family":"Dargaud","sequence":"additional","affiliation":[{"name":"University Claude Bernard Lyon 1, Faculty of Medicine Lyon-Est, Auvergne-Rh\u00f4ne-Alpes, France","place":["Oullins-Pierre-B\u00e9nite"],"department":["Hemostasis & Thrombosis Research Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alastair","family":"Nimmo","sequence":"additional","affiliation":[{"name":"Royal Infirmary of Edinburgh, United Kingdom of Great Britain and Northern Ireland","place":["Edinburgh"],"department":["Department of Anaesthesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.tmrv.2004.11.003","article-title":"Coagulation disorders and blood product use in patients undergoing thoracoabdominal aortic aneurysm repair","volume":"19","author":"C S Cin\u00e0","year":"2005","journal-title":"Transfus Med Rev"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/anae.15866","article-title":"Major haemorrhage: past, present and future","volume":"78","author":"A Shah","year":"2023","journal-title":"Anaesthesia"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1186\/s13054-024-05026-7","article-title":"Plasma for prevention and treatment of glycocalyx degradation in trauma and 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