Fibrinogen concentrate as first-line therapy in children undergoing cardiac surgery: Promising perspectives

Our plain-English summary of Fibrinogen concentrate as first-line therapy in children undergoing cardiac surgery: Promising perspectives, by D. Faraoni (The Journal of Thoracic and Cardiovascular Surgery, 2015).

The study

• Author: D. Faraoni
• Journal: The Journal of Thoracic and Cardiovascular Surgery
• Published: 2015;149(5):1466-7
• Type of article: Letter, Comment
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This item is a letter to the editor, not a research study, and it is not about asbestos. The author, an anesthesiologist in Brussels, commented on a randomized pilot trial by Galas and colleagues. That trial compared fibrinogen concentrate with cryoprecipitate as first-line treatment for bleeding in children after cardiac surgery. The author noted that the trial was not powered to detect differences in bleeding or transfusion needs. The author also noted that cryoprecipitate is no longer available in most European countries, where fresh frozen plasma is usually used instead. In the author's view, a comparison with fresh frozen plasma would probably have favored fibrinogen concentrate. About 40% of children in both groups of that trial received extra cryoprecipitate, which the author said could suggest the starting doses were not adequate. Citing a pediatric study, the author argued that maximal clot firmness on the bedside FIBTEM test should be preferred to guide fibrinogen replacement, and proposed a treatment algorithm. The letter reported no new data of its own.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: letter to the editor (commentary on another published trial); no original data
• Who was studied: No study population of its own; the letter discusses a published randomized pilot trial in bleeding children after cardiac surgery (Galas and colleagues)
• Exposure: Not asbestos. Fibrinogen concentrate (60 mg/kg) versus cryoprecipitate (10 mL/kg) as first-line treatment for bleeding after cardiopulmonary bypass, as used in the trial discussed
• Main results:
  • The author noted that the Galas trial was not powered to detect differences in postoperative bleeding or transfusion requirements
  • The author noted that cryoprecipitate is no longer available in most European countries, where fresh frozen plasma is usually used first
  • The author's opinion was that a comparison with fresh frozen plasma would probably have favored fibrinogen concentrate
  • The author pointed out that about 40% of children in both groups of the Galas trial received additional cryoprecipitate, which the author said could suggest the initial doses were not adequate
• The authors' conclusion: The author concluded that maximal clot firmness on FIBTEM should be preferred to guide fibrinogen replacement, and proposed a transfusion algorithm for children undergoing cardiac surgery

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: First-line Therapy.

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