General

Synonym/Acronym:
Factor I.

Rationale
Commonly used to determine whether a fibrinogen (factor I) deficiency (acquired or inherited) is the source of abnormal bleeding. Also used to monitor severity and treatment of disseminated intravascular coagulation (DIC) and severe liver disease.

Patient Preparation
There are no food, fluid, activity, or medication restrictions unless by medical direction.

Normal Findings
Method: Electromagnetic mechanical clot detection.

Critical Findings and Potential Interventions

• Less than 80 mg/dL (SI: Less than 2.4 micromol/L).
• Greater than 800 mg/dL (SI: Greater than 23.5 micromol/L).

Timely notification to the requesting health-care provider (HCP) of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.

Signs and symptoms of microvascular thrombosis include cyanosis, ischemic tissue necrosis, hemorrhagic necrosis, tachypnea, dyspnea, pulmonary emboli, venous distention, abdominal pain, and oliguria. Possible interventions include identification and treatment of the underlying cause, support through administration of required blood products (cryoprecipitate or fresh frozen plasma), and administration of heparin. Cryoprecipitate may be a more effective product than fresh frozen plasma in cases where the fibrinogen level is less than 100 mg/dL (SI = 2.94 micromol/L), the minimum level required for adequate hemostasis, because it delivers a concentrated amount of fibrinogen without as much plasma volume.