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Encapsulation of Cardiomyocytes in a Fibrin Hydrogel for Cardiac Tissue Engineering
Published on: September 19, 2011
Fibrinogen concentrate therapy in complex cardiac surgery
Süleyman Bilecen1, Linda M Peelen, Cor J Kalkman
1Department of Cardiothoracic Anaesthesia and Intensive Care, Isala Clinics, Zwolle, The Netherlands. s.bilecen@umcutrecht.nl
Journal of Cardiothoracic and Vascular Anesthesia
|July 24, 2012
Summary
Fibrinogen concentrate did not reduce blood loss or transfusions in complex cardiac surgery patients. No increased risk of adverse clinical events was observed, suggesting potential limitations in dosage or timing of intervention.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Hematology
Background:
- Fibrinogen concentrate is increasingly used for coagulopathic bleeding in cardiac surgery.
- Its effectiveness and safety in this context remain unproven.
Purpose of the Study:
- To quantify the effects of fibrinogen concentrate on postoperative blood loss and transfusion.
- To assess the occurrence of adverse clinical events following its use in complex cardiac surgery patients.
Main Methods:
- Prospective cohort analysis of 1,075 patients undergoing complex cardiac surgery (2007-2010).
- Nonrandomized intervention involving fibrinogen concentrate administration during surgery.
- Adjusted analysis to evaluate outcomes including blood loss, transfusion, and adverse events.
Main Results:
- Fibrinogen concentrate did not significantly reduce postoperative blood loss (geometric mean ratio 1.02) or transfusion rates (odds ratio 1.14).
- No significant increase in the risk of 30-day mortality, myocardial infarction, stroke, renal failure, infections, or prolonged ventilation was observed.
- Adjusted odds ratios for adverse events ranged from 0.62 to 1.44, indicating no clear increased risk.
Conclusions:
- Fibrinogen concentrate infusion during complex cardiac surgery did not decrease postoperative blood loss or transfusion requirements.
- No elevated risk of clinical adverse events was detected.
- Lower doses and late intervention may have limited hemostatic efficacy; a randomized trial is underway.
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