Fibrinogen supplementation in cardiac surgery: Where are we now and where are we going?

摘要

THIS ISSUE OF THE Journal of Cardiothoracic and Vascular Anesthesia includes 2 interesting contributions focused on fibrinogen levels after coronary artery bypass grafting (CABG) with or without cardiopulmonary bypass (CPB) and on fibrinogen supplementation after complex cardiac surgery (CABG plus valve surgeries or ascending aorta surgeries).2 Momeni et al,1 in an elegant study, including conventional coagulation tests and point-of-care (POC) tests (Multiplate, Verum Diagnostica GmbH, Munich, Germany and ROTEM, Tern International GmbH, Munich, Germany), found that patients undergoing CABG with CPB exhibited significantly lower values of fibrinogen during and after the surgeries compared with patients treated off-pump. In addition, they found that the values of fibrinogen obtained with the FIBTEM test using the ROTEM system correlated well with the conventional Clauss measurement.