CRITICAL CARE Bleeding management with fibrinogen concentrate targeting a high-normal plasma fibrinogen level: a pilot study

Methods. A blood products transfusion algorithm was developed using retrospective data from 42 elective patients (Group A). Two units of platelet concentrate were transfused after cardiopulmonary bypass, followed by 4 u of FFP if bleeding persisted, if platelet count was 100 10 ml when removing the aortic clamp, and vice versa if platelet count was .100 10 ml. The trigger for each therapy step was 60 g blood absorbed from the mediastinal wound area by dry swabs in 5 min. Assignment to two prospective groups was neither randomized nor blinded; Group B (n=5) was treated according to the algorithm, Group C (n=10) received fibrinogen concentrate (Haemocomplettan P/Riastap, CSL Behring, Marburg, Germany) before the algorithm-based therapy.