Patients with severe cyanosis and an age >12 months randomly received conventional treatment with or without fibrinogen concentrate after complex heart surgery. Postoperative FFP requirements, duration of mechanical ventilation and ICU stay could be reduced by fibrinogen supplementation. Despite major methodological limitations (blinding and treatment algorithm insufficiently defined, small sample size), the study indicates improved quality of care in this high-risk population by implementing a pathophysiology-driven management protocol.

– Sibylle Kozek-Langenecker