title: [Perioperative fibrinogen concentrations in cardiac surgery with cardiopulmonary bypass].
abstract: BACKGROUND
  Patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) need many blood products due to deficiency of coagulation factors. Blood transfusion therapy in patients with excessive bleeding after CPB is generally empiric. We checked and studied the fibrinogen concentration and transfusion, as well as bleeding amount in the perioperative period.
  
  
  METHODS
  The study was approved by our institutional ethics committee. Thirty patients were studied. Blood samples were obtained at the induction of anesthesia (before CPB), at the end of CPB, at the end of operation, and on the next morning, or before the patient was given fresh frozen plasma in the intensive care unit.
  
  
  RESULTS
  For all cases, fibrinogen concentration and platelet concentration were lowest at the end of CPB. Fibrinogen concentration rose up to before CPB level on the next morning. The group in which fibrinogen concentration was less than 150 mg x dl(-1) at the end of CPB consumed more blood products than the group with fibrinogen concentration of over 150 mg x dl(-1).
  
  
  CONCLUSIONS
  Blood transfusion therapy based on fibrinogen concentration is needed to maintain adequacy of the perioperative blood transfusion and blood conservation in cardiac surgery.
authors.affiliation: Department of Anesthesia, Tenri Hospital, Tenri 632-8552.
authors.forename: Makiko
authors.initials: M
authors.lastname: Uji
authors.forename: Yuki
authors.initials: Y
authors.lastname: Terada
authors.forename: Teruo
authors.initials: T
authors.lastname: Noguchi
authors.forename: Takaya
authors.initials: T
authors.lastname: Nishida
authors.forename: Kyoko
authors.initials: K
authors.lastname: Hasuwa
authors.forename: Kozue
authors.initials: K
authors.lastname: Shinohara
authors.forename: Hotaka
authors.initials: H
authors.lastname: Kumano
authors.forename: Naoko
authors.initials: N
authors.lastname: Ishimura
authors.forename: Makoto
authors.initials: M
authors.lastname: Nishiwada
mesh_terms: D015415:Biomarkers / Q000097:blood; D001803:Blood Transfusion; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D059035:Perioperative Period; D010949:Plasma; D019106:Postoperative Hemorrhage / Q000175:diagnosis* / Q000628:therapy
chemical_list: D015415:Biomarkers; D005340:Fibrinogen