title: A randomized, double blind trial of prophylactic fibrinogen to reduce bleeding in cardiac surgery.
abstract: OBJECTIVE
  Postoperative bleeding has a great clinical importance and can contribute to increased mortality and morbidity in patients undergoing coronary artery bypass graft surgery. In this prospective, randomized, double-blind study, we evaluated the effect of prophylactic administration of fibrinogen concentrate on post-coronary artery bypass graft surgery bleeding.
  
  
  METHODS
  A total of 60 patients undergoing coronary artery bypass surgery were randomly divided into two groups. Patients in the fibrinogen group received 1g of fibrinogen concentrate 30 min prior to the operation, while patients in the control group received placebo. Post-operative bleeding volumes, prothrombin time, partial thromboplastin time, INR, hemoglobin and transfused blood products in both groups were recorded. A strict red blood cell transfusion protocol was used in all patients.
  
  
  RESULTS
  There were no significant differences between intra-operative packed red blood cells infusion in the studied groups (1.0±1.4 in fibrinogen group, and 1.3±1.1 in control group). Less postoperative bleeding was observed in the fibrinogen group (477±143 versus 703±179, p=0.0001). Fifteen patients in the fibrinogen group and 21 in the control group required post-op packed red blood cells infusion (p=0.094). No thrombotic event was observed through 72 h after surgery.
  
  
  CONCLUSIONS
  Prophylactic fibrinogen reduces post-operative bleeding in patients undergoing coronary artery bypass graft.
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Sadeghi
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Atefyekta
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Omid
authors.initials: O
authors.lastname: Azimaraghi
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Mojtaba
authors.initials: SM
authors.lastname: Marashi
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Yasaman
authors.initials: Y
authors.lastname: Aghajani
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Ghadimi
authors.affiliation: Management University and University Hospital Zurich, Zurich, Switzerland.
authors.forename: Donat R
authors.initials: DR
authors.lastname: Spahn
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran. Electronic address: movafegh@sina.tums.ac.ir.
authors.forename: Ali
authors.initials: A
authors.lastname: Movafegh
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods*; D004311:Double-Blind Method; D017707:Erythrocyte Transfusion; D005260:Female; D005340:Fibrinogen / Q000008:administration & dosage*; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011446:Prospective Studies
chemical_list: D006490:Hemostatics; D005340:Fibrinogen
keywords: Bleeding; Blood transfusion; Cardiac surgery; Cardiopulmonary bypass; Circulação extracorpórea; Cirurgia cardíaca; Hemostasia; Hemostasis; Sangramento; Transfusão de sangue