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Bilecen and colleagues report their experience with fibrinogen concentrate in a non-randomized cohort of bleeding patients undergoing complex cardiac surgery. No reduction in blood loss or transfusion requirements was found in the fibrinogen-treated group compared to those not receiving fibrinogen. Likewise, no difference in postoperative morbidity or mortality was found. The authors correctely conclude that there is an urgent need for a randomized, double-blind clinical trial addressing the clinical utility of fibringen concentrate in bleeding cardiac surgery patients.

– Pär I. Johansson