Effect of Local Fibrinogen Administration on Postoperative Bleeding in Coronary Artery Bypass Graft Patients
Journal of Cellular & Molecular Anesthesia,
Vol. 1 No. 1 (2016),
21 Azar 2015
,
Page 23-27
https://doi.org/10.22037/jcma.v1i1.10597
Abstract
Background: There are always concerns regarding postoperative bleeding in coronary artery bypass graft (CABG) patients; several different strategies have been used to compensate for it and to reduce the amount of blood transfusion. We designed this study to investigate local fibrinogen conditions in postoperative bleeding in adult patients undergoing CABG.
Materials and Methods: In a double-blind clinical trial, after matching the inclusion and exclusion criteria, 50 patients entered the study. Pre- and postoperative data, including clinical and laboratory variables were assessed. Among them, preoperative and postoperative fibrinogen levels were measured. One group received 1g fibrinogen as a 50mL solution flushed over the epicardium before sternal closure; the other received 50mL normal saline as a placebo in the same method.
Results: No difference between the two groups regarding preoperative and postoperative fibrinogen levels. Also, the two groups were the same regarding PT, PTT, INR, and platelet. However, bleeding was less and hematocrit level was higher in the local fibrinogen group.
Conclusion: Local fibrinogen could decrease postoperative bleeding in CABG patients leading to decreased need for blood transfusion.
- fibrinogen
- coronary artery bypass graft
- postoperative bleeding
How to Cite
References
Colombo GL, Bettoni D, Di Matteo S, Grumi C, Molon C, Spinelli D, et al. Economic and outcomes consequences of TachoSil®: a systematic review. Vasc Health Risk Manag. 2014;10:569-75.
Rousou JA. Use of fibrin sealants in cardiovascular surgery: a systematic review. J Card Surg. 2013;28(3):238-47.
Payani N, Foroughi M, Dabbagh A. The Effect of Intravenous Administration of Active Recombinant Factor VII on Postoperative Bleeding in Cardiac Valve Reoperations; A Randomized Clinical Trial. Anesth Pain Med. 2015;5(1):e22846.
Martinez M, Weisel JW, Ischiropoulos H. Functional impact of oxidative posttranslational modifications on fibrinogen and fibrin clots. Free Radic Biol Med. 2013;65:411-8.
Ranucci M, Baryshnikova E, Colella D. Monitoring prohemostatic treatment in bleeding patients. Semin Thromb Hemost. 2012;38(3):282-91.
Dell'Amore A, Caroli G, Nizar A, Cassanelli N, Luciano G, Greco D, et al. Can topical application of tranexamic acid reduce blood loss in thoracic surgery? A prospective randomised double blind investigation. Heart Lung Circ. 2012;21(11):706-10.
Levy JH, Sniecinski RM. Prohemostatic treatment in cardiac surgery. Semin Thromb Hemost. 2012;38(3):237-43..
Levy JH, Tanaka KA. Prohemostatic agents to prevent perioperative blood loss. Semin Thromb Hemost. 2008;34(5):439-44.
Rickenbacher A, Breitenstein S, Lesurtel M, Frilling A. Efficacy of TachoSil a fibrin-based haemostat in different fields of surgery--a systematic review. Expert Opin Biol Ther. 2009;9(7):897-907.
Momeni M, Carlier C, Baele P, Watremez C, Van Dyck M, Matta A, et al. Fibrinogen concentration significantly decreases after on-pump versus off-pump coronary artery bypass surgery: a systematic point-of-care ROTEM analysis. J Cardiothorac Vasc Anesth. 2013;27(1):5-11.
Alizadeh Ghavidel A, Mirmesdagh Y, Samiei N, Gholampour Dehaki M. Haemostatic Role of TachoSil Surgical Patch in Cardiac Surgery. J Cardiovasc Thorac Res. 2014;6(2):91-5.
Canonico S. The use of human fibrin glue in the surgical operations. Acta Biomed. 2003;74 Suppl 2:21-5.
Filosso PL, Ruffini E, Sandri A, Lausi PO, Giobbe R, Oliaro A. Efficacy and safety of human fibrinogen-thrombin patch (TachoSil®) in the treatment of postoperative air leakage in patients submitted to redo surgery for lung malignancies: a randomized trial. Interact Cardiovasc Thorac Surg. 2013;16(5):661-6.
Karlsson M, Ternström L, Hyllner M, Baghaei F, Flinck A, Skrtic S, et al. Prophylactic fibrinogen infusion reduces bleeding after coronary artery bypass surgery. A prospective randomised pilot study. Thromb Haemost. 2009;102(1):137-44.
Karlsson M, Ternström L, Hyllner M, Baghaei F, Skrtic S, Jeppsson A. Prophylactic fibrinogen infusion in cardiac surgery patients: effects on biomarkers of coagulation, fibrinolysis, and platelet function. Clin Appl Thromb Hemost. 2011;17(4):396-404.
- Abstract Viewed: 329 times
- PDF Downloaded: 306 times