Breakthrough coma reversal with glue

January 2, 2008 9:37:45 AM PST
Fibrin glue is a useful substance most commonly used to control bleeding in certain surgical patients. It is made up of fibrinogen and thrombin. These two substances, when mixed together, form a glue that mimics the final stages of clotting. In some cases, calcium chloride and/or antifibrinolytics are added to the fibrin glue. Once the glue is applied, it forms a fibrin clot. Fibrin glue is applied with a double-barrel syringe, or sometimes by spraying the glue onto the desired area. The fibrinogen portion of fibrin glue is obtained from a blood donor and is isolated using cryoprecipitation. The safest preparations of fibrin glue are made from a patient's own blood. Fibrin glue is available in Europe and is not yet commercially available in the United States.

Source: DF Thompson et al.

TRADITIONAL USES: Fibrin glue is used for a variety of different clinical applications. The most common use of the glue is to seal together a surgical incision. It is particularly useful in sealing a delicate incision in which sutures or metal clips would be too invasive. In cardiovascular or thoracic surgery, fibrin glue can be sprayed on the heart and areas of the chest and throat to stop bleeding. Fibrin glue may also be used in patients who suffer from hemophilia to stop external bleeding. Orthopedic and plastic surgery procedures sometimes include using fibrin glue as well.

Source: British Medical Journal, 1994;308:933-934

REVERSAL OF COMA: Sixty-eight-year-old Algis Bliudzius was already in a coma when he arrived to Cedars-Sinai Medical Center in Los Angeles. For two days, he had been suffering from headaches that only presented themselves when he was standing upright. He was diagnosed with spontaneous intracranial hypotension, which was caused by a small hole in the dura (part of the casing that surrounds the brain and spinal cord), through which his spinal fluid was leaking. Because of the spinal fluid leak, Bliudzius' brain was sagging in his skull when he changed positions. Doctors first took a standard approach to treating the spinal fluid leak. They injected a blood patch into the patient's dura at the site where the fluid was leaking. Initially, this worked and Bliudzius was able to regain consciousness. But 48 hours later, the patient was drifting in and out of consciousness again. At that point, doctors administered 2 milliliters of fibrin glue to the leak site in the dura. The next day, Bliudzius was not only conscious, but he was able to walk freely, and his headache was gone.

Source: The Lancet, 2007;369:1402

FOR MORE INFORMATION, PLEASE CONTACT:

Nilou Salimpour
Public Relations
Cedars-Sinai Medical Center
Los Angeles, CA
salimpourn@cshs.org
(310) 246-9889


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