Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

The role of fibrinogen and fibrinogen concentrate in cardiac surgery: an international consensus statement from the Haemostasis and Transfusion Scientific Subcommittee of the European Association of Cardiothoracic Anaesthesiology

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Challenges in optimising recovery after emergency laparotomy

    Publikation: Bidrag til tidsskriftReviewForskningpeer review

  2. Variation in the practice of tracheal intubation in Europe after traumatic brain injury: a prospective cohort study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Enhanced postoperative recovery: good from afar, but far from good?

    Publikation: Bidrag til tidsskriftReviewForskningpeer review

  4. The clinical implication of the association between hypoxaemia and postoperative troponin I: a reply

    Publikation: Bidrag til tidsskriftKommentar/debatForskningpeer review

  1. Mechanical respiratory support in cardiogenic shock: reply

    Publikation: Bidrag til tidsskriftKommentar/debatForskningpeer review

  2. Domain-specific cognitive dysfunction after cardiac surgery. A secondary analysis of a randomized trial

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Hypotension and Stroke in Cardiac Surgery: Comment

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • G Erdoes
  • A Koster
  • M I Meesters
  • E Ortmann
  • D Bolliger
  • E Baryshnikova
  • A Ahmed
  • M D Lance
  • H B Ravn
  • M Ranucci
  • C von Heymann
  • S Agarwal
Vis graf over relationer

To date, data regarding the efficacy and safety of administering fibrinogen concentrate in cardiac surgery are limited. Studies are limited by their low sample size and large heterogeneity with regard to the patient population, by the timing of fibrinogen concentrate administration, and by the definition of transfusion trigger and target levels. Assessment of fibrinogen activity using viscoelastic point-of-care testing shortly before or after weaning from cardiopulmonary bypass in patients and procedures with a high risk of bleeding appears to be a rational strategy. In contrast, the use of Clauss fibrinogen test for determination of plasma fibrinogen level can no longer be recommended without restrictions due to its long turnaround time, high inter-assay variability and interference with high heparin levels and fibrin degradation products. Administration of fibrinogen concentrate for maintaining physiological fibrinogen activity in the case of microvascular post-cardiopulmonary bypass bleeding appears to be indicated. The available evidence does not suggest aiming for supranormal levels, however. Use of cryoprecipitate as an alternative to fibrinogen concentrate might be considered to increase plasma fibrinogen levels. Although conclusive evidence is lacking, fibrinogen concentrate does not seem to increase adverse outcomes (i.e., thromboembolic events). Large prospective multi-centre studies are needed to better define the optimal perioperative monitoring tool, transfusion trigger and target levels for fibrinogen replacement in cardiac surgery.

OriginalsprogEngelsk
TidsskriftAnaesthesia
Vol/bind74
Udgave nummer12
Sider (fra-til)1589-1600
Antal sider12
ISSN0003-2409
DOI
StatusUdgivet - 2019

Bibliografisk note

© 2019 Association of Anaesthetists.

ID: 58987657