Fibrinogen concentrate as an alternative to cryoprecipitate in a postcardiopulmonary transfusion algorithm in infants undergoing cardiac surgery: a prospective randomized controlled trial.

This is an excellent multicentre prospective randomised trial evaluating the efficacy of fibrinogen concentrate (FC) compared to cryoprecipitate to achieve haemostasis for infants post-cardiopulmonary bypass.

The primary outcome was the difference in the number of intraoperative blood product transfusions. Secondary outcomes included 24-hour chest tube output, mechanical ventilation time, adverse events, intensive care unit length of stay, hospital length of stay, postoperative thrombosis, and death within 30 days of surgery.

The FC group actually received fewer blood products than the cryoprecipitate group. There was no difference in any of the secondary outcomes. This study supports the use of FC to achieve haemostasis in infants undergoing cardiopulmonary bypass.

– Eloa Adams (SABM reviewer)