Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jun 1;9(3):e91199.
doi: 10.5812/aapm.91199. eCollection 2019 Jun.

The Effect of Fibrinogen on Blood Loss After Lumbar Surgery: A Double-Blind Randomized Clinical Trial

Fatemeh Javaherforoosh Zadeh  1 , Farahzad Janatmakan  1 , Mohsen Shafaee Tonekaboni  1 , Mansoor Soltanzadeh  1
Affiliations

The Effect of Fibrinogen on Blood Loss After Lumbar Surgery: A Double-Blind Randomized Clinical Trial

Fatemeh Javaherforoosh Zadeh et al. Anesth Pain Med. .

Abstract

Background: Spinal surgeries often have a high risk of hemorrhage during and after surgery, thus most patients require blood transfusions and blood products. Fibrinogen is used in different forms to control hemorrhage.

Objectives: The present study aimed to evaluate the outcomes of prophylactic fibrinogen administration in reducing hemorrhage after lumbar surgery.

Methods: This was a randomized clinical trial conducted on 30 patients undergoing lumbar surgery. The levels of fibrinogen, as well as hemoglobin (HB), hematocrit (HCT), prothrombin time (PT), partial thromboplastin time (PTT), and INR, were assessed preoperatively as the baseline values. The patients were divided into two groups: intervention (N = 15) and control (N = 15) groups. The intervention group received 1 g fibrinogen dissolved in 50 cc distilled water with surgical incision and the control group received 50 cc distilled water with the surgical incision. At the end of the operation, the volume of hemorrhage transfused blood products (fresh frozen plasma, packed cell, and platelet) was measured. In addition, at 0, 6, and 24 hours after the end of surgery and transfer to recovery, serum levels of fibrinogen, HB, HCT, INR, PT, PTT, and hemovac drain volume were measured.

Results: The hemorrhage during and after the operation in the control group was significantly higher than that of the intervention group (P < 0.05). There were no significant differences between hemoglobin and serum level of fibrinogen before and after surgery between the two groups. The postoperative hypotension showed no significant difference between the two groups.

Conclusions: The findings showed the effectiveness of fibrinogen in reducing acute hemorrhage. Considering the adverse consequences of hemorrhage and coagulopathy in patients undergoing surgery, using fibrinogen as prophylaxis is recommended in surgeries with high risks of hemorrhage.

Keywords: Fibrinogen; Hemorrhage; Lumbar Surgery.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. Flow diagram
See this image and copyright information in PMC

References

    1. Wen L, Jin D, Xie W, Li Y, Chen W, Ding J, et al. Hidden blood loss in posterior lumbar fusion surgery: An analysis of risk factors. Clin Spine Surg. 2018;31(4):180–4. doi: 10.1097/BSD.0000000000000626. - DOI - PubMed
    1. Javaherforooshzadeh F, Monajemzadeh SA, Soltanzadeh M, Janatmakan F, Salari A, Saeed H. A comparative study of the amount of bleeding and hemodynamic changes between dexmedetomidine infusion and remifentanil infusion for controlled hypotensive anesthesia in lumbar discopathy surgery: A double-blind, randomized, clinical trial. Anesthesiol Pain Med. 2018;8(2) doi: 10.5812/aapm.66959. - DOI - PMC - PubMed
    1. Irita K. [Present status of critical hemorrhage and its management in the operating room.]. Rinsho Byori. 2014;62(12):1275–9. - PubMed
    1. Yang L, Vuylsteke A, Gerrard C, Besser M, Baglin T. Postoperative fibrinogen level is associated with postoperative bleeding following cardiothoracic surgery and the effect of fibrinogen replacement therapy remains uncertain. J Thromb Haemost. 2013;11(8):1519–26. doi: 10.1111/jth.12304. - DOI - PubMed
    1. McQuilten ZK, Crighton G, Engelbrecht S, Gotmaker R, Brunskill SJ, Murphy MF, et al. Transfusion interventions in critical bleeding requiring massive transfusion: A systematic review. Transfus Med Rev. 2015;29(2):127–37. doi: 10.1016/j.tmrv.2015.01.001. - DOI - PubMed

LinkOut - more resources