Fibrinogen in traumatic haemorrhage: A narrative review

Injury. 2017 Feb;48(2):230-242. doi: 10.1016/j.injury.2016.12.012. Epub 2016 Dec 26.


Haemorrhage in the setting of severe trauma is associated with significant morbidity and mortality. There is increasing awareness of the important role fibrinogen plays in traumatic haemorrhage. Fibrinogen levels fall precipitously in severe trauma and the resultant hypofibrinogenaemia is associated with poor outcomes. Hence, it has been postulated that early fibrinogen replacement in severe traumatic haemorrhage may improve outcomes, although, to date there is a paucity of high quality evidence to support this hypothesis. In addition there is controversy regarding the optimal method for fibrinogen supplementation. We review the current evidence regarding the role of fibrinogen in trauma, the rationale behind fibrinogen supplementation and discuss current research.

Keywords: Coagulopathy; Cryoprecipitate; Fibrinogen; Fibrinogen concentrate; Massive transfusion; Trauma; Viscoelastic haemostatic assays.

Publication types

  • Review

MeSH terms

  • Australia / epidemiology
  • Craniocerebral Trauma / complications
  • Craniocerebral Trauma / mortality
  • Craniocerebral Trauma / therapy*
  • Fibrinogen / therapeutic use*
  • Hemostatics / therapeutic use*
  • Humans
  • Intracranial Hemorrhage, Traumatic / complications
  • Intracranial Hemorrhage, Traumatic / mortality
  • Intracranial Hemorrhage, Traumatic / therapy*
  • Practice Guidelines as Topic
  • Treatment Outcome


  • Hemostatics
  • Fibrinogen