Prophylactic Use of Fibrinogen Concentrate on Postoperative Blood Fibrinogen Levels, Amount of Bleeding, and the Need for Blood Transfusion in Normofibrinogenemic Patients Undergoing Coronary Artery Bypass Graft Surgery

Khadijeh Ghavibonyeh; Ali Dabbagh; Alireza Jahangirifard; Ramin Baghaei; Kamal Fani; Marzieh Shahrabi; Mina Fani

doi:10.18502/aacc.v12i3.21316

Khadijeh Ghavibonyeh Department of Anesthesiology and Critical Care, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ali Dabbagh Department of Anesthesiology and Critical Care, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Alireza Jahangirifard Department of Anesthesiology and Critical Care, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ramin Baghaei Department of Cardiac Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Kamal Fani Department of Cardiac Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Marzieh Shahrabi Department of Anesthesiology and Critical Care, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mina Fani School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v12i3.21316

Keywords: Fibrinogen concentrate; Perioperative bleeding; Normofibrinogenemia; Coronary artery bypass graft surgery

Abstract

Background: Different studies investigated strategies to prevent perioperative bleeding in cardiac surgeries. The use of fibrinogen concentrate is one of these efforts. In this study, we will investigate the efficacy and proper dosage of fibrinogen concentrate as a prophylactic adjuvant for reducing postoperative bleeding in patients with normal blood fibrinogen under coronary artery bypass grafting (CABG) surgery.

Methods: Patients with preoperative normal plasma fibrinogen levels were randomly divided into two groups (15 patients in each). At the final stage of cardiac surgery and after reversal of heparin, the first group received 2gr of fibrinogen IV concentrate in 15 minutes, while the other group received the same volume of placebo. In each patient, postoperative haematocrit percentage, intraoperative and postoperative administered blood products, and postoperative drainage amount were collected.

Results: Although in the study group, the postoperative amount of plasma fibrinogen increased compared to preoperative and decreased in the control group, but this change was not statistically significant. Also there wasn’t any significant difference in terms of blood drainage and blood product consumption.

Conclusion: We did not find evidence of a significant difference in the change of fibrinogen blood level before and after the operation, the amount of drainage, and the consumption of blood products in the fibrinogen and placebo groups.