Fibrinogen concentrate reduces intraoperative bleeding when used as first-line hemostatic therapy during major aortic replacement surgery: Results from.

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Fibrinogen concentrate reduces intraoperative bleeding when used as first-line hemostatic therapy during major aortic replacement surgery: Results from a randomized, placebo-controlled trial Niels Rahe-Meyer, MD, MSc, PhD, Alexander Hanke, MD, Dirk S. Schmidt, PhD, Christian Hagl, MD, Maximilian Pichlmaier, MD The Journal of Thoracic and Cardiovascular Surgery Volume 145, Issue 3, Pages S178-S185 (March 2013) DOI: 10.1016/j.jtcvs.2012.12.083 Copyright © 2013 Terms and Conditions

Figure 1 CONSORT flow diagram of patient progression through this parallel, randomized trial. ∗Patients did not receive the allocated intervention because the rate of bleeding was less than 60 g/5 min or more than 250 g/5 min, FIBTEM maximum clot firmness was greater than the 22-mm target level, or because there was a late decision not to proceed with aortic replacement surgery. The Journal of Thoracic and Cardiovascular Surgery 2013 145, S178-S185DOI: (10.1016/j.jtcvs.2012.12.083) Copyright © 2013 Terms and Conditions

Figure 2 Sequence of intraoperative events illustrating the timing of measurements of the rate of bleeding and administration of hemostatic therapies, and the time-points used to calculate changes in the rate of bleeding (Δrate) after different hemostatic interventions. CPB, Cardiopulmonary bypass; FC, fibrinogen concentrate; FFP, fresh-frozen plasma; FIBTEM, fibrin-based thromboelastometry test. The Journal of Thoracic and Cardiovascular Surgery 2013 145, S178-S185DOI: (10.1016/j.jtcvs.2012.12.083) Copyright © 2013 Terms and Conditions

Figure 3 A, Individual patient data for changes in the rate of coagulopathic bleeding after treatment with placebo, 1 cycle of transfusion, 2 cycles of transfusion, or fibrinogen concentrate. B, Changing trends in the rate of bleeding after treatment with placebo, 1 cycle of transfusion, 2 cycles of transfusion, or fibrinogen concentrate. Grey dotted line, no effect. The Journal of Thoracic and Cardiovascular Surgery 2013 145, S178-S185DOI: (10.1016/j.jtcvs.2012.12.083) Copyright © 2013 Terms and Conditions