Contribution of fibrin glue in the surgery of cyanogenic and non-cyanogenic congenital cardiopathies: retrospective cohort study

• Published in: BMC cardiovascular disorders Vol. 19; no. 1; p. 117
• Main Authors: Cheikh, Amine, Ajaja, Mohamed Rida, Rhazali, Hicham, Bouatia, Mustapha, Benomar, Ali, Slaoui, Anas, Cherrah, Yahia, Abouqal, Redouane, El Hassani, Amine, Cheikhaoui, Younes
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 16-05-2019; BioMed Central; BMC
• Subjects: Age; Analysis; Bleeding; Blood; Blood transfusion; Cardiac Surgical Procedures - adverse effects; Cardiovascular surgery; Child; Child health; Child, Preschool; Clinical trials; Cohort analysis; Complications and side effects; Compression; Congenital cardiopathies; Congenital diseases; Cyanogenic; Cyanosis - diagnosis; Cyanosis - etiology; Electrocoagulation; Erythrocyte Transfusion; Erythrocytes; Female; Fibrin; Fibrin glue; Fibrin Tissue Adhesive - adverse effects; Fibrin Tissue Adhesive - therapeutic use; Genetic disorders; Health care costs; Healthcare industry software; Heart; Heart Defects, Congenital - complications; Heart Defects, Congenital - diagnosis; Heart Defects, Congenital - surgery; Heart surgery; Hemorrhage; Hemostasis; Hospitals; Humans; Infant; Intensive care; Length of Stay; Male; Medical research; Morocco; Non-cyanogenic; Patients; Pediatric cardiology; Pediatrics; Physiology; Plasma; Platelet Transfusion; Platelets; Postoperative Hemorrhage - etiology; Postoperative Hemorrhage - prevention & control; Retrospective Studies; Risk factors; Sealing compounds; Surgery; Sutures; Thoracic surgery; Time Factors; Tissue Adhesives - adverse effects; Tissue Adhesives - therapeutic use; Treatment Outcome; Morocco; Non-cyanogenic; Congenital cardiopathies; Fibrin glue; Cyanogenic
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-019-1102-7

Postoperative bleeding in cardiovascular surgery is a frequent and complicated situation for the surgical team, and may also be responsible for significant hospital expenditures. Fibrin glue are indicated in surgery to improve hemostasis when conventional techniques such as compression, sutures or electrocoagulation are insufficient. Through this study, we tried to study the contribution of fibrin glue to the improvement of the clinical parameters (volume of postoperative bleeding, length of stay in intensive care, volume of blood transfusion ...) in two populations having undergone cardiac surgery, one in which we used the fibrin glue and one without fibrin glue.
This was a retrospective cohort study conducted in the cardiovascular surgery department of our Hospital in Rabat between June 2012 and June 2015. Fibrin glue (Tissucol® of BAXTER) was used in one group with an haemostatic aim. The pre and post-operative clinical data of the patients were analyzed and compared with data from patients who were operated without the use of fibrin glue because it was not yet available in the hospital. The clinical parameters were collected analyzed using the SPSS 13.0 software.
One hundred ten patients were included in this study. The fibrin glue was used intraoperatively in 55 patients and not used in 55 patients. 43 (39.1%) had cyanogenic diseases and 67 (60.9%) had non-cyanogenic pathologies. The volume of transfused red blood cells was lower in patients in whom we used biological glue (p = 0.005), as well as the number of days spent in intensive care (p = 0.02). However, the difference was not significant between the two groups for other parameters such as bleeding volume per kg, the number of units of fresh frozen plasma and the platelet units count transfused.
The results we found show that fibrin glue reduces the duration of hospitalization in resuscitation and reduces the number of units of transfused red blood cells to patients after surgery. However, it does not reduce significantly the total postoperative bleeding volume per weight, the number of fresh frozen plasma units or platelets units transfused. The fibrin glue could therefore be of moderate benefit in pediatric cardiac surgery.