Influence of Preop Fibrinogen on Blood in Pediatric Cardiac Surgery

CHU Brugmann University Hospital

Status: Completed

Conditions: Cardiac Surgery; Fibrinogenemia; Cardiopulmonary Bypass; Congenital Heart Disease

Treatments: Procedure: Congenital cardiac surgery

Study type: Observational

Funder types: Other

Identifiers

NCT05525195

card_ped_fibri

Details and patient eligibility

About

Fibrinogen plays an important role in the coagulation cascade. Low levels of preoperative fibrinogen have been associated in adults with higher blood and transfusion requirements during surgery. Guidelines from the European Society of Anesthesiology and Intensive Care recommends fibrinogen substitution based on viscoelastic tests in adult cardiac surgery. Cardiopulmonary bypass results in a profound hemodilution and dilution of all coagulation factors. This is especially true in children where the priming volume of the cardiopulmonary bypass circuit is much higher compared to the patient's weight than in adults. Cardiopulmonary bypass generates high levels of tissue plasminogen activator resulting in a hyperfibrinolysis, further lowering fibrinogen levels.

The aim of this retrospective study is to explore a possible relationship between preoperative fibrinogen levels and perioperative blood loss, as well as transfusion requirements in children undergoing cardiac surgery.

Enrollment: 932 patients

Sex: All

Ages: Under 16 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• all children with cardiac surgery under cardiopulmonary bypass between 2008 and 2018
• Age < 16 year

Exclusion criteria

• preoperative coagulopathy
• Jehovah's witnesses
• patients with fresh frozen plasma in the priming of the cardiopulmonary bypass circuit