Fibrinogen concentrate reduces intraoperative bleeding when used as first-line hemostatic therapy during major aortic replacement surgery: Results from a randomized, placebo-controlled trial.

This study is, essentially, a comparison between fibrinogen concentrate, placebo and the use of 1 liter of fresh frozen plasma and/or 2 pools of platelets in reducing bleeding after cardiopulmonary bypass (CPB) in 59 patients post CPB. Fibrinogen reduced bleeding rate significantly more than other parameters. More efficacy studies are necessary and they will also need to address safety, the key question being: if fibrinogen levels are increased intraoperatively, does this lead ot an increased rate of thrombosis postoperatively?

– Beverley J. Hunt