• Mostafa Sadeghi, Reza Atefyekta, Omid Azimaraghi, Seyed Mojtaba Marashi, Yasaman Aghajani, Fatemeh Ghadimi, Donat R Spahn, and Ali Movafegh.
• Tehran University of Medical Sciences, Tehran, Iran.
• Braz J Anesthesiol. 2014 Jul 1;64(4):253-7.

Background And ObjectivesPostoperative bleeding has a great clinical importance and can contribute to increased mortality and morbidity in patients undergoing coronary artery bypass graft surgery. In this prospective, randomized, double-blind study, we evaluated the effect of prophylactic administration of fibrinogen concentrate on post-coronary artery bypass graft surgery bleeding.MethodsA total of 60 patients undergoing coronary artery bypass surgery were randomly divided into two groups. Patients in the fibrinogen group received 1g of fibrinogen concentrate 30 min prior to the operation, while patients in the control group received placebo. Post-operative bleeding volumes, prothrombin time, partial thromboplastin time, INR, hemoglobin and transfused blood products in both groups were recorded. A strict red blood cell transfusion protocol was used in all patients.ResultsThere were no significant differences between intra-operative packed red blood cells infusion in the studied groups (1.0±1.4 in fibrinogen group, and 1.3±1.1 in control group). Less postoperative bleeding was observed in the fibrinogen group (477±143 versus 703±179, p=0.0001). Fifteen patients in the fibrinogen group and 21 in the control group required post-op packed red blood cells infusion (p=0.094). No thrombotic event was observed through 72 h after surgery.ConclusionProphylactic fibrinogen reduces post-operative bleeding in patients undergoing coronary artery bypass graft.Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

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