Overview
Fibrinogen concentrate is produced by different manufacturers using different purification technologies. The products available in Italy are three: RIASTAP (CSL Behring), FIBRYGA (Octapharma), and FIBRICLOTTE (LFB). RIASTAP and FIBRYGA are sold in 1-gram vials, and FIBRICLOTTE - in 1.5 grams vials. A recent in vitro study assessed how these products affected the clot firmness measured by the ROTEM FIBTEM maximum clot firmness (MCF) parameter. In vitro conditions, FIBRICLOTTE was verified to be the most efficient in increasing clot firmness.
The present study is aimed to assess, in a series of patients undergoing cardiac surgery with cardiopulmonary bypass, the hypothesis that the FIBRICLOTTE fibrinogen is superior to the RIASTAP fibrinogen in increasing the FIBTEM MCF parameter in a clinical model of bleeding (postoperative bleeding after complex cardiac surgery).
Eligibility
Inclusion Criteria:
- elective cardiac surgery with cardiopulmonary bypass;
- complex cardiac surgery (coronary artery bypass graft + valve repair/replacement; double/triple valve repair/replacement; ascendant aorta surgery);
- written consent to participate;
Exclusion Criteria:
- urgent or emergent cardiac surgery;
- known hypersensitivity to the active principle or to one of the excipients of the study drugs;
- coagulation disorders, known or presumable from anamnesis;
- known hepatopathy;
- known risk of thrombosis or disseminated intravascular coagulation;
- participation in another clinical study where an experimental product has been administered within 30 days from the day of the inclusion in the study;
- whatever clinical condition that, in the opinion of the investigator, makes the patients not suitable to the experimentation.