effect of local fibrinogen administration on postoperative bleeding in coronary artery bypass graft patients

introduction : there is always concerns regarding postoperative bleeding in coronary artery bypass graft (cabg) patients; a number of different strategies have been used to compensate for it and to reduce the amount of blood transfusion. we designed this study to see if local fibrinogen could decrease postoperative bleeding in adult cabg, which is not studied yet. materials and methods : in a double blind clinical trial, after matching the inclusion and exclusion criteria, 50 patients entered the study. pre- and postoperative data, including clinical and laboratory variables were assessed. among them, pre- and postoperative fibrinogen levels were measured. one group received 1 g fibrinogen as 50 ml solution flushed over the epicardium before sternal closure; the other received 50 ml normal saline as placebo in the same method. results : no difference between the two groups regarding preoperative and postoperative fibrinogen levels. also, two groups were the same regarding pt, ptt, inr and platelet. however, bleeding was less and hematocrit level was higher in local fibrinogen group. conclusion : local fibrinogen could decrease postoperative bleeding in cabg patients leading to decreased need for blood transfusion. key words: fibrinogen; coronary artery bypass graft; postoperative bleeding