The effect of fibrinogen infusion applied after cardiopulmonary artery bypass graft surgery: Retrospective comparative study

Abstract

OBJECTIVE: The effect of administered fibrinogen concentrates in reducing the risk of postoperative bleeding that remains a serious problem in open heart surgery is controversial. We aimed to present the effect of fibrinogen concentrates on postoperative bleeding applied after cardiopulmonary bypass (CPB) in coronary artery bypass grafting (CABG).MATERIAL AND METHODS: 67 patients who underwent CABG and measured below 2.5 g / L fibrinogen after CPB were included in the study. Data of 32 patients (Group F; n=32 patients) who were given fibrinogen concentrate were compared with 35 patients (Group NF; n=35 patients) who were not given fibrinogen concentrate.RESULTS: After CPB, fibrinogen concentrate was applied to patients in order to increase fibrinogen levels to 2.5 g/L and above. For both groups, fibrinogen levels decreased significantly after CPB compared to preoperative levels (p<0.01), however, there was no difference between the groups in terms of reduction rate (p = 0.321). 2.94±0.91 g fibrinogen was administered to the patients in Group F. Postoperative drainage between the groups was not significant in both the 0-12 hour period (p=0.142) and 12-24 hour period(p = 0.309).CONCLUSIONS: Fibrinogen concentrate may reduce the amount of postoperative drainage with secondary effects which increased low plasma fibrinogen levels and contributes to recovery of coagulation physiology. However, because this decrease was not statistically significant, we think that fibrinogen concentrates should be used only in patients with a high risk of bleeding and in patients with fibrinogen levels below <1.5 g/L after CPB.