{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T09:11:11Z","timestamp":1791882671500,"version":"4.3.4"},"reference-count":37,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,10,7]],"date-time":"2014-10-07T00:00:00Z","timestamp":1412640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>We compared blood component requirements during major obstetric haemorrhage, following the introduction of fibrinogen concentrate. A prospective study of transfusion requirements and patient outcomes was performed for 12\u00a0months to evaluate the major obstetric haemorrhage pathway using shock packs (Shock Pack phase). The study was repeated after the pathway was amended to include fibrinogen concentrate (Fibrinogen phase). The median (IQR [range]) number of blood components given was 8.0 (3.0\u201314.5 [0\u201332]) during the Shock Pack phase, and 3.0 (2.0\u20135.0 [0\u201326]) during the Fibrinogen phase (p\u00a0=\u00a00.0004). The median (IQR [range]) quantity of fibrinogen administered was significantly greater in the Shock Pack phase, 3.2\u00a0(0\u20137.1 [0\u201320.4])\u00a0g, than in the Fibrinogen phase, 0\u00a0(0\u20133.0 [0\u201312.4]) g, p\u00a0=\u00a00.0005. Four (9.5%) of 42 patients in the Shock Pack phase developed transfusion associated circulatory overload compared with none of 51 patients in the Fibrinogen phase (p\u00a0=\u00a00.038). Fibrinogen concentrate allows prompt correction of coagulation deficits associated with major obstetric haemorrhage, reducing the requirement for blood component therapy and the attendant risks of complications.<\/jats:p>","DOI":"10.1111\/anae.12859","type":"journal-article","created":{"date-parts":[[2014,10,7]],"date-time":"2014-10-07T08:55:47Z","timestamp":1412672147000},"page":"166-175","source":"Crossref","is-referenced-by-count":194,"title":["Introduction of an algorithm for\n                    <scp>ROTEM<\/scp>\n                    \u2010guided fibrinogen concentrate administration in major obstetric haemorrhage"],"prefix":"10.1111","volume":"70","author":[{"given":"S.","family":"Mallaiah","sequence":"first","affiliation":[{"name":"Liverpool Women's Hospital Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Barclay","sequence":"additional","affiliation":[{"name":"Liverpool Women's Hospital Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Harrod","sequence":"additional","affiliation":[{"name":"Liverpool Women's Hospital Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Chevannes","sequence":"additional","affiliation":[{"name":"Liverpool Women's Hospital Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Bhalla","sequence":"additional","affiliation":[{"name":"Liverpool Women's Hospital Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,10,7]]},"reference":[{"issue":"1","key":"e_1_2_7_2_1","first-page":"1","article-title":"Saving Mothers\u2019 Lives: reviewing maternal deaths to make motherhood safer: 2006\u20132008. 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