Novel autologous, high concentrated fibrin as advanced hemostatic agent for coronary surgery

医学 止血 纤维蛋白 外科 自体血 止血剂 前瞻性队列研究 动脉 输血 旁路移植 随机对照试验 心脏外科 麻醉 免疫学
作者
Slobodan Mićović,Peter A. Everts,Branko Čalija,Evgenija Strugarević,Nikola Grubor,Mladen Boricic,Jelena Lesanovic,Henk A.M. Box,Džihan Abazović
出处
期刊:Transfusion and Apheresis Science [Elsevier BV]
卷期号:60 (4): 103171-103171 被引量:10
标识
DOI:10.1016/j.transci.2021.103171
摘要

Variability in transfusion outcomes and excessive postoperative bleeding represents a significant problem in cardiac surgery. The effort to reduce bleeding complications and transfusion outcomes is desirable. Our study investigated the feasibility of reducing bleeding complications and transfusion requirements by applying perioperatively prepared autologous bio-regenerative fibrin sealant.A prospective, case-control study enrolled 74 patients undergoing coronary artery bypass grafting by a single surgeon. Patients in the control group (N = 43), received traditional methods of hemostasis, while patients in the experimental group (N = 31) were treated additionally with autologous bio-regenerative fibrin.Patients were well-matched with regard to basic demographic, laboratory and procedural data. Allogeneic blood transfusion requirement in control group was 39.5 % (17 of 43 patients), compared to 6.5 % (2 of 31 patients) in treated group (p < 0,001). The lower infection rate in the experimental group was also noted. No safety issues were identified during the preparation and application process.Autologous bio-regenerative fibrin can be safely prepared, with no time consuming, and was demonstrated to be a useful tool to decrease allogeneic blood transfusion requirements following elective coronary artery bypass grafting surgery. A prospective randomized trial is needed to confirm these findings.
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