Treatment effects of fibrinogen concentrates vs. cryoprecipitate for correcting hypofibrinogenemia in cardiac surgery patients: a systematic review and meta-analysis

作者：Yue Chen, Wenjie Yang, Chongyang Zhao, Fujue Wang, Pengwei Ren, Xuemei Liu, Tingyong Cao, Shuming Ji, Lei Chen, Deying Kang · 发表于：Frontiers in Cardiovascular Medicine · 年份：2025 · DOI：10.3389/fcvm.2025.1671405 · 被引用次数：2 · 研究领域：Trauma, Hemostasis, Coagulopathy, Resuscitation、Blood properties and coagulation、Blood transfusion and management

Background Hypofibrinogenemia in cardiac surgery increases bleeding risk, but the efficacy and safety of fibrinogen concentrate vs. cryoprecipitate remain unclear. This meta-analysis compares the patient-important outcomes associated with the use of fibrinogen concentrate vs. cryoprecipitate for the management of acquired hypofibrinogenemia in cardiac surgery. Methods Medline, Embase, Cochrane Library, and Transfusion Evidence Library were searched from their inception until June 2024. Eligible studies included randomized clinical trials (RCTs). Effect estimates were synthesized using risk ratios (RR) and standardized mean differences (SMD), along with their corresponding 95% confidence intervals (CIs). Results We analyzed 4 RCTs (945 participants: 823 adults, 122 children) comparing fibrinogen concentrate with cryoprecipitate undergoing cardiac surgery. Meta-analysis showed no difference in mortality (RR = 1.25, 95% CI: 0.79–1.96; moderate GRADE), blood loss (SMD = −0.14, 95% CI: −0.46–0.18), transfusion rates (blood cells: RR = 0.98, 0.77–1.26; platelets: RR = 0.17, 0.02–1.40; fresh frozen plasma: RR = 0.48, 0.16–1.45; cryoprecipitate: RR = 1.02, 0.58–1.81), infections (RR = 0.91, 0.64–1.28), volume overload (RR = 1.95, 0.18–21.34), transfusion reactions (RR = 0.98, 0.06–15.54), or postoperative thrombosis (RR = 0.76, 0.47–1.22). No allergic reactions were reported. Subgroup analysis revealed substantial heterogeneity (I 2 = 0% to 98%) in most outcome measures between adult...