Gibbs et al evaluated plasma fibrinogen concentrations after cardiac surgery with cardiopulmonary bypass. This can help to identify a patient with hypofibrinogenemia who may be at risk for bleeding. The authors are from Sir Charles Gardner Hospital and St John of God Hospital in Australia.
Patient selection: cardiopulmonary bypass with hemodilution
Parameters:
(1) initial hemoglobin in g/dL
(2) final hemoglobin in g/dL
(3) initial fibrinogen in g/L
percent fall in hemoglobin =
= ((initial hemoglobin) - (final hemoglobin)) / (initial hemoglobin) * 100%
Eye-balling Figure 1:
percent fall in fibrinogen =
= 1.125 * (percent fall in hemoglobin)
predicted fibrinogen concentration after the procedure =
= (initial fibrinogen) * (1 - (1.125 * (percent fall in hemoglobin)))
Hypofibrinogenemia was defined as a plasma fibrinogen less than 150 mg/dL.
The prediction assumes that the fall in hemoglobin and fibrinogen about the same. Transfusion of blood products may affect one more than the other.
