FIESTY Trial Summary: Fibrinogen in Severe Trauma

FIESTY trial fibrinogen trauma

2021 FEISTY TRIAL Fibrinogen early in severe trauma study | multicentre, randomized controlled pilot study s Objective: To compare the time to fibrinogen replacement using f ibrinogen concentrate (FC) or cryoprecipitate (Cryo) in severely injured trauma patients with major hemorrhage & hypofibrinogenemia E 100 patients Inclusion criteria: Participants > 18 years with clinically significant hemorrhage or potential for significant transfusion requirements with assessment of blood consumption ABC score of 2 Fibrinogen concentrate (n=50) Cryoprecipitate (n=50) PRIMARY OUTCOME Time to commencement of fibrinogen replacement (in mins) P = 0.0001 SECONDARY OUTCOME 3.4 FIBTEM A5 amplitude (mm) Diff 2.6; 95% CI, 1.1 to 4.1; P = 0.001 2.6 0.56 FibC level (g/L) Diff 0.78; 95% CI, 0.34 to 1.2; P < 0.0005 0.90 Conclusion: Fibrinogen replacement in severely injured trauma patients with major hemorrhage and hypofibrinogenemia was achieved substantially faster using FC compared with Cryo. Fibrinogen levels increased appropriately using either product. J. Winearls et al. Crit Care Resusc 2021; 23 (1): 32-46