부산대학교 도서관

Purpose Hemocoagulase, a hemostatic, is used in patients with trauma, gastrointestinal bleeding, or pulmonary hemorrhage or those undergoing surgery. However, cases of acquired hypofibrinogenemia and paradoxical bleeding associated with hemocoagulase administration have been reported. In this study we evaluate the risk factors associated with acquired hypofibrinogenemia in patients with hemocoagulase batroxobin administration for hemoptysis. Methods We reviewed medical charts of hospitalized patients receiving hemocoagulase batroxobin for hemoptysis from January 2020 to April 2021 at a tertiary hospital. Acquired hypofibrinogenemia was defined as a plasma fibrinogen level more than 200 mg/ dL at baseline and decreased to less than 200 mg/dL after hemocoagulase administration. Results Total 186 patients were enrolled. Mean age was 68.4 ± 13.9 years, and male was predominant (63.4%). Most common cause of hemoptysis was bronchiectasis (59%). Mean duration of batroxobin administration was 3.5 ± 0.2 days and mean dosage of batroxobin was 35.3 ± 2.0 U. One hundred six patients (57.0%) developed acquired hypofibrinogenemia after administration of batroxobin. Recurrence of bleeding during hospitalization was more frequent in patients with acquired hypofibrinogenemia (22.6% vs. 6.3%; P=0.002). Multivariate analysis with logistic regression revealed longer duration of batroxobin administration was associated with acquired hypofibrinogenemia (odds ratio, 1.40; 95% confidence interval, 1.12-1.74; P=0.003). Conclusion Long duration of hemocoagulase use is associated with acquired hypofibrinogenemia and increased risk of rebleeding. Therefore, it is necessary to measure plasma fibrinogen levels regularly in patients with hemocoagulase administration.