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Can plasma fibrinogen levels predict bleeding after coronary artery bypass grafting?
Alireza Jalali1, Mohammadsaeid Ghiasi1, Aghdas Aghaei2
1Department of Cardiac Anesthesiology, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
Insights
Preoperative fibrinogen levels do not predict bleeding after coronary artery bypass grafting (CABG). This study found no correlation between fibrinogen concentration and postoperative bleeding, suggesting it
Area of Science:
- Cardiovascular Surgery
- Hematology
- Anesthesiology
Background:
- Fibrinogen is a key biomarker for bleeding, crucial for identifying patients at risk of excessive blood loss.
- Predicting postoperative bleeding before coronary artery bypass grafting (CABG) is essential for patient management.
Purpose of the Study:
- To investigate the association between preoperative fibrinogen concentration and the amount of bleeding following CABG.
- To determine if plasma fibrinogen levels can serve as a predictor for post-CABG bleeding.
Main Methods:
- A case-series study included 144 patients undergoing elective, isolated CABG.
- Standardized anesthesia techniques and medications were used for all participants.
- Bleeding was assessed at 12 and 24 hours post-operation, along with blood product transfusion data.
Main Results:
- Postoperative bleeding volumes averaged 285.37 ± 280.27 mL at 12 hours and 499.31 ± 355.57 mL at 24 hours.
- Pre-anesthesia fibrinogen concentration showed no significant correlation with bleeding at either 12 or 24 hours post-CABG.
- Extracorporeal circulation time was correlated with bleeding at both 12 (P = 0.007) and 24 hours (P = 0.013).
Conclusions:
- Preoperative plasma fibrinogen levels are not a reliable predictor of post-CABG bleeding.
- Other factors, such as extracorporeal circulation time, may be more influential in predicting bleeding after CABG.
Background:
Fibrinogen is the main biomarker for bleeding. To prevent excessive postoperative bleeding, it would be useful to identify high-risk patients before coronary artery bypass grafting (CABG).
Objectives:
In order to predicating bleeding after CABG, we sought to determine whether preoperative fibrinogen concentration was associated with the amount of bleeding following CABG.
Patients And Methods:
A total of 144 patients (mean age = 61.50 ± 9.42 years; 65.7% men), undergoing elective and isolated CABG, were included in this case-series study. The same anesthesia technique and medicines were selected for all the patients. In the ICU, the patients were assessed in terms of bleeding at 12 and 24 hours post-operation, amount of contingent blood products received, and relevant tests. Statistical tests were subsequently conducted to analyze the correlation between preoperative fibrinogen concentration and the amount of post-CABG bleeding.
Results:
The mean ± standard deviation of bleeding at 12 and 24 hours post-operation was 285.37 ± 280.27 and 499.31 ± 355.57 mL, respectively. The results showed that postoperative bleeding was associated with different factors whereas pre-anesthesia fibrinogen was not correlated with bleeding at 12 (P = 0.856) and 24 hours (P = 0.936) post-operation. There were correlations between the extra-corporal circulation time and bleeding at 12 hours post-operation (ρ = 0.231, P = 0.007) and bleeding at 24 hours post-operation (ρ = 0.218, P = 0.013).
Conclusions:
Preoperative assessment of plasma fibrinogen levels failed to predict post-CABG bleeding.
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