Abstract: Objective To monitor the coagulation changes via thrombelastography in patients with in vitro simulated traumatic hypofibrinogenemia under different levels of fibrinogen, and to provide a basis for guiding its clinical treatment. Methods Six samples of suspended red blood cells, fresh frozen plasma and apheresis platelets were collected from healthy donors who passed the physical examination and laboratory tests in our center. Then we constructed 10 groups of traumatic hypofibrinogenemia models with fibrinogen concentrations of 0.5 g/L, 0.7 g/L, 0.9 g/L, 1.1 g/L, 1.3 g/L, 1.5 g/L, 2.0 g/L, 2.5 g/L, 3.0 g/L, and 3.5 g/L in vitro. Blood routine, PT, APTT, Fib, and thromboelastogram (TEG) of 10 group models were tested, and statistical analysis and linear regression equation established. An in vitro model of 60% blood loss of traumatic hypofibrinogenemia was developed, and fibrinogen was supplemented according to the linear regression equation to verify the role of TEG guidance in the treatment of traumatic hypofibrinogenemia. Results When the concentration of fibrinogen was lower than 2.0g/L, a negative correlation was observed between Fig and K values, the linear regression equation being -0.160×K+2.113; and Fib was positively correlated with Angle and MA values, the linear regression equation being -1.006×A+0.055, and -0.498×MA+0.040. There was a difference between the theoretical and actual increase in K value in the supplemented fibrinogen model (t=-4.355, P=0.007), but not between the theoretical and actual added values of Angle and MA (t=-1.300, P=0.250; t=0.463, P=0.663). Conclusions Angle and MA values in TEG can effectively monitor the changes in coagulation function of patients during treatment of traumatic hypofibrinogenemia. Fibrinogen supplementation can be used to correct traumatic hypofibrinogenemia based on linear regression equations.

Key words: Fibrinogen, Thromboelastogram, Traumatic low-fibroproteinemia, Coagulation function