# Advancements in Fibrinogen Replacement for Major Bleeding: Insights From Case Series

## TL;DR

This case series examines how replacing fibrinogen with specific treatments helps manage severe bleeding in cardiac, obstetric, and trauma cases.

## Contribution

The study highlights the clinical benefits of rapid fibrinogen repletion using fibrinogen concentrate or pathogen-reduced cryoprecipitate.

## Key findings

- Fibrinogen replacement using FC or pathogen-reduced cryoprecipitate improved outcomes in critical bleeding scenarios.
- Timely fibrinogen repletion is essential for effective hemostasis in patients with acquired fibrinogen deficiency.
- Viscoelastic testing can guide optimal treatment choices for fibrinogen replacement.

## Abstract

This case series explores the role of fibrinogen replacement in managing major bleeding across cardiac, obstetric, and trauma contexts. Acquired fibrinogen deficiency (AFD) frequently complicates hemostasis during major bleeding by impairing clot stability. We examine three cases where fibrinogen is repleted with fibrinogen concentrate (FC) or pathogen-reduced cryoprecipitate, rather than cryoprecipitate, to manage perioperative bleeding in cardiac surgery, postpartum hemorrhage, and trauma-induced coagulopathy. These cases underscore the need for timely fibrinogen replacement in critical bleeding situations, highlighting potential clinical benefits of rapid repletion of fibrinogen, and, in addition, we review ideal treatment options based upon viscoelastic testing (VET).