Cardiothoracic & vascular anesthesia
Superiority of Fibrinogen Concentrate Versus Cryoprecipitate for Treatment of Bleeding in Cardiac Surgery Patients: A Secondary Analysis of the FIBRES Randomized Clinical Trial Stratified by Surgical Risk
Authors' conclusion
FC showed superior hemostatic efficacy to cryoprecipitate in the prespecified subgroups of elective cardiac surgery patients and patients who were not in a critical state before surgery, representing the large majority of patients with bleeding postbypass.
Study context
- Population
- Adult cardiac surgery patients with significant postbypass bleeding and acquired hypofibrinogenemia (fibrinogen <2.0 g/L or FIBTEM A10 <10 mm), 11 Canadian hospitals, February 2017-November 2018included in primary analysis
- Participants
- 735 patients
- Comparison
- Fibrinogen concentrate vs cryoprecipitate
- Fibrinogen concentrate (FC)n = 372
- Cryoprecipitaten = 363reference
- Primary endpoint
- Cumulative blood components (red cells, platelets, plasma) administered
- Follow-up
- Within 24 hours postbypass
Methodological detailsmulticentre, a priori-defined subgroups, stratified by surgical risk
- Multicentre
- A priori-defined subgroups
- Stratified by surgical risk
Primary result
As reported in the abstract
Mean ratio
0.84
95% CI 0.73–0.96P = 0.01
FC (non-critically ill) vs Cryoprecipitate (non-critically ill) · n = 634, 86% of population
Mean ratio
0.81
95% CI 0.69–0.96P = 0.02
FC (elective surgery) vs Cryoprecipitate (elective surgery) · n = 466, 63% of population
FC (non-critically ill)
13.6
mean · units
Cryoprecipitate (non-critically ill)
16.2
mean · units
FC (elective surgery)
11.7
units
Cryoprecipitate (elective surgery)
14.4
units
Safety
| Outcome | RR (CI) | P value | |
|---|---|---|---|
| Adverse events (elective surgery subgroup)Less frequent with FC | 0.85 (0.75–0.97) | P = 0.02 | |
| Serious adverse events (elective surgery subgroup)Less frequent with FC | 0.71 (0.52–0.99) | P = 0.04 | |
| 0.512Relative risk (log scale) |
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →