Fibrinogen Concentrate Therapy in Complex Cardiac Surgery

JAMA, 2017

Fibrinogen concentrate might partly restore coagulation defects and reduce intraoperative bleeding. To determine whether fibrinogen concentrate infusion dosed to achieve a plasma fibrinogen level of 2.5 g/L in high-risk cardiac surgery patients with intraoperative bleeding reduces intraoperative blood loss. A randomized, placebo-controlled, double-blind clinical trial conducted in Isala Zwolle, the Netherlands (February 2011-January 2015), involving patients undergoing elective, high-risk cardiac surgery (ie, combined coronary artery bypass graft [CABG] surgery and valve repair or replacement surgery, the replacement of multiple valves, aortic root reconstruction, or reconstruction of the ascending aorta or aortic arch) with intraoperative bleeding (blood volume between 60 and 250 mL suctioned from the thoracic cavity in a period of 5 minutes) were randomized to receive either fibrinogen concentrate or placebo. Intravenous, single-dose administration of fibrinogen concentrate (n = 6...

Anaesthesia, 2019

Anesthesia & Analgesia, 2018

Journal of the American Heart Association, 2015

Postoperative bleeding after heart operations is still a common finding, leading to allogeneic blood products transfusion. Fibrinogen and coagulation factors deficiency are possible determinants of bleeding. The experimental hypothesis of this study is that a first-line fibrinogen supplementation avoids the need for fresh frozen plasma (FFP) and reduces the need for any kind of transfusions. This was a single-center, prospective, randomized, placebo-controlled, double-blinded study. One-hundred sixteen patients undergoing heart surgery with an expected cardiopulmonary bypass duration >90 minutes were admitted to the study. Patients in the treatment arm received fibrinogen concentrate after protamine administration; patients in the control arm received saline solution. In case of ongoing bleeding, patients in the treatment arm could receive prothrombin complex concentrates (PCCs) and those in the control arm saline solution. The primary endpoint was avoidance of any allogeneic blo...

Journal of Cardiothoracic and Vascular Anesthesia, 2013

Brazilian Journal of Anesthesiology (English Edition), 2013

Annals of Cardiac Anaesthesia, 2018

The Journal of Thoracic and Cardiovascular Surgery, 2016

British Journal of Anaesthesia, 2010

Journal of Thrombosis and Haemostasis, 2013