A randomized, double blind trial of prophylactic fibrinogen to reduce bleeding in cardiac surgery

作者：Sadeghi Mostafa; Atefyekta Reza; Azimaraghi Omid; Marashi Seyed Mojtaba; Aghajani Yasaman; Ghadimi Fatemeh; Spahn Donat R; Movafegh Ali^*

来源：Revista Brasileira de Anestesiologia, 2014, 64(4): 253-257.

DOI：10.1016/j.bjane.2013.10.010

• Blood transfusion
• Bleeding
• Cardiac surgery
• Cardiopulmonary bypass
• Hemostasis

Background and objectives: Postoperative bleeding has a great clinical importance and can contribute to increased mortality and morbidity in patients undergoing coronary artery bypass graft surgery. In this prospective, randomized, double-blind study, we evaluated the effect of prophylactic administration of fibrinogen concentrate on post-coronary artery bypass graft surgery bleeding. %26lt;br%26gt;Methods: A total of 60 patients undergoing coronary artery bypass surgery were randomly divided into two groups. Patients in the fibrinogen group received 1 g of fibrinogen concentrate 30 min prior to the operation, while patients in the control group received placebo. Postoperative bleeding volumes, prothrombin time, partial thromboplastin time, INR, hemoglobin and transfused blood products in both groups were recorded. A strict red blood cell transfusion protocol was used in all patients. %26lt;br%26gt;Results: There were no significant differences between intra-operative packed red blood cells infusion in the studied groups (1.0 +/- 1.4 in fibrinogen group, and 1.3 +/- 1.1 in control group). Less postoperative bleeding was observed in the fibrinogen group (477 +/- 143 versus 703 +/- 179, p=0.0001). Fifteen patients in the fibrinogen group and 21 in the control group required postop packed red blood cells infusion (p=0.094). No thrombotic event was observed through 72h after surgery. %26lt;br%26gt;Conclusion: Prophylactic fibrinogen reduces post-operative bleeding in patients undergoing coronary artery bypass graft.

• 出版日期2014-8