Efficacy and Safety of Fibrinogen Concentrate in Surgical Patients: A Meta-analysis of Randomized Controlled Trials

B leeding is a common and prominent complication during and after surgery. Excessive blood loss is associated with prolonged length of intensive care and mechanical ventilation, increased morbidity and mortality, and higher overall health care costs. Blood product transfusions are used for the management of bleeding and coagulopathy, but the use of allogeneic red blood cells (RBCs) and fresh frozen plasma can lead to adverse outcomes after surgery. Treating coagulopathic bleeding using fibrinogen concentrate (FC) could reduce the use of allogeneic blood product transfusion as fibrinogen contributes to the achievement and maintenance of hemostasis. A meta-analysis of randomized controlled studies (RCTs) comparing fibrinogen supplementation with placebo or other hemostatic treatments (fresh frozen plasma, platelets, cryoprecipitate, and coagulation factor concentrates) in the perioperative setting was carried out to investigate the effects