A randomised controlled trial of fibrinogen concentrate during scoliosis surgery

Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China. Department of Orthopedics Surgery, Peking Union Medical College Hospital, Beijing, China. Medical Research Center, Peking Union Medical College Hospital, Beijing, China.

Anaesthesia. 2020
PICO Summary

Population

Patients between 12 to 18 years old having surgery for idiopathic scoliosis (n= 102).

Intervention

Intraoperative fibrinogen concentrate (30 mg.kg−1, maximum 2 g), (n= 51).

Comparison

Saline placebo (n= 51).

Outcome

Fibrinogen concentrate infusion reduced median perioperative bleeding by about 155ml compared with placebo. Fibrinogen did not reduce postoperative blood transfusion or increase postoperative haemoglobin concentration.
Abstract
Bleeding and blood transfusion are common after scoliosis surgery. Fibrinogen is essential for blood clot formation and depletes quickly during haemorrhage. We randomly allocated 102 children 12-18 years old having surgery for idiopathic scoliosis, 51 to intra-operative fibrinogen concentrate 30 mg.kg(-1) (maximum 2 g) and 51 to saline placebo. Fibrinogen reduced peri-operative blood loss by a median (95%CI) volume of 155 (5-320) ml, from a median (IQR [range]) of 1035 (818-1420 [400-3030]) ml to 885 (755-1155 [270-2645]) ml, p = 0.04. Seven and four children received allogeneic red blood cell transfusion after fibrinogen and placebo, respectively, p = 0.34. There were no side-effects.
Study details
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine