Human Fibrinogen Concentrate in Pediatric Cardiac Surgery

NCT ID: NCT02822599

Last Updated: 2021-09-16

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-06-01

Study Completion Date

2020-12-24

Brief Summary

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The goal of the study is to determine whether the use of Human Fibrinogen Concentrate (RiaSTAP) will decrease blood loss and the need for component blood therapy in neonates and infants undergoing cardiopulmonary bypass.

Detailed Description

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The goal of the study is to determine whether the use of Human Fibrinogen Concentrate (RiaSTAP) will decrease blood loss and the need for component blood therapy in neonates and infants undergoing cardiopulmonary bypass. RiaSTAP will be administered after termination of Cardiopulmonary Bypass (CPB) at a dose of 70 mg/kg, in a prospective, randomized, controlled study. We hypothesize that the administration of RiaSTAP in this manner will reduce peri-operative bleeding and transfusion requirements.

Conditions

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Hypofibrinogenemia Afibrinogenemia Bleeding Disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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RiaSTAP

Group 1 will receive an infusion of RiaSTAP after termination of CPB at a dose of 70 mg/kg after randomization to this group.

Group Type ACTIVE_COMPARATOR

RiaStAP

Intervention Type DRUG

To decrease post-operative bleeding volume.

Saline

Group 2 will receive a placebo consisting of Normal Saline 0.9% (NS) after randomization to this group.

Group Type PLACEBO_COMPARATOR

Saline

Intervention Type DRUG

Placebo consisting of normal saline 0.9%

Interventions

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RiaStAP

To decrease post-operative bleeding volume.

Intervention Type DRUG

Saline

Placebo consisting of normal saline 0.9%

Intervention Type DRUG

Other Intervention Names

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Fibrinogen Concentrate Human Normal Saline 0.9%

Eligibility Criteria

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Inclusion Criteria

* Neonatal and infant cardiac patients presenting for open-heart surgery at Nicklaus Children's Hospital will be eligible for enrollment in the study.

Exclusion Criteria

* Patients who fall outside of the age range for the study will be excluded. Patients known to have had an anaphylactic or severe reaction to the drug or its components will not be enrolled. At the time of the rewarming ROTEM, any patient with a FIBTEM MCF \> 15mm, will be excluded.
Minimum Eligible Age

1 Day

Maximum Eligible Age

1 Year

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Nicklaus Children's Hospital f/k/a Miami Children's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Christopher Tirotta, MD, MBA

Director Cardiac Anesthesia

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Christopher Tirotta, MD

Role: PRINCIPAL_INVESTIGATOR

Director Cardiac Anesthesia

Locations

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Nickalus Children's Hospital f/k/a Miami Children's Hospital

Miami, Florida, United States

Site Status

Nicklaus Children's Hospital

Miami, Florida, United States

Site Status

Countries

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United States

References

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Dacey LJ, Munoz JJ, Baribeau YR, Johnson ER, Lahey SJ, Leavitt BJ, Quinn RD, Nugent WC, Birkmeyer JD, O'Connor GT. Reexploration for hemorrhage following coronary artery bypass grafting: incidence and risk factors. Northern New England Cardiovascular Disease Study Group. Arch Surg. 1998 Apr;133(4):442-7. doi: 10.1001/archsurg.133.4.442.

Reference Type BACKGROUND
PMID: 9565127 (View on PubMed)

Moulton MJ, Creswell LL, Mackey ME, Cox JL, Rosenbloom M. Reexploration for bleeding is a risk factor for adverse outcomes after cardiac operations. J Thorac Cardiovasc Surg. 1996 May;111(5):1037-46. doi: 10.1016/s0022-5223(96)70380-x.

Reference Type BACKGROUND
PMID: 8622301 (View on PubMed)

Paparella D, Brister SJ, Buchanan MR. Coagulation disorders of cardiopulmonary bypass: a review. Intensive Care Med. 2004 Oct;30(10):1873-81. doi: 10.1007/s00134-004-2388-0. Epub 2004 Jul 24.

Reference Type BACKGROUND
PMID: 15278267 (View on PubMed)

Miller BE, Tosone SR, Guzzetta NA, Miller JL, Brosius KK. Fibrinogen in children undergoing cardiac surgery: is it effective? Anesth Analg. 2004 Nov;99(5):1341-1346. doi: 10.1213/01.ANE.0000134811.27812.F0.

Reference Type BACKGROUND
PMID: 15502028 (View on PubMed)

Kern FH, Morana NJ, Sears JJ, Hickey PR. Coagulation defects in neonates during cardiopulmonary bypass. Ann Thorac Surg. 1992 Sep;54(3):541-6. doi: 10.1016/0003-4975(92)90451-9.

Reference Type BACKGROUND
PMID: 1510523 (View on PubMed)

Chan AK, Leaker M, Burrows FA, Williams WG, Gruenwald CE, Whyte L, Adams M, Brooker LA, Adams H, Mitchell L, Andrew M. Coagulation and fibrinolytic profile of paediatric patients undergoing cardiopulmonary bypass. Thromb Haemost. 1997 Feb;77(2):270-7.

Reference Type BACKGROUND
PMID: 9157580 (View on PubMed)

Karlsson M, Ternstrom L, Hyllner M, Baghaei F, Nilsson S, Jeppsson A. Plasma fibrinogen level, bleeding, and transfusion after on-pump coronary artery bypass grafting surgery: a prospective observational study. Transfusion. 2008 Oct;48(10):2152-8. doi: 10.1111/j.1537-2995.2008.01827.x. Epub 2008 Jul 24.

Reference Type BACKGROUND
PMID: 18657083 (View on PubMed)

Karlsson M, Ternstrom L, Hyllner M, Baghaei F, Flinck A, Skrtic S, Jeppsson A. Prophylactic fibrinogen infusion reduces bleeding after coronary artery bypass surgery. A prospective randomised pilot study. Thromb Haemost. 2009 Jul;102(1):137-44. doi: 10.1160/TH08-09-0587.

Reference Type BACKGROUND
PMID: 19572078 (View on PubMed)

Rahe-Meyer N, Pichlmaier M, Haverich A, Solomon C, Winterhalter M, Piepenbrock S, Tanaka KA. Bleeding management with fibrinogen concentrate targeting a high-normal plasma fibrinogen level: a pilot study. Br J Anaesth. 2009 Jun;102(6):785-92. doi: 10.1093/bja/aep089. Epub 2009 May 2.

Reference Type BACKGROUND
PMID: 19411671 (View on PubMed)

Tirotta CF, Lagueruela RG, Gupta A, Salyakina D, Aguero D, Ojito J, Kubes K, Hannan R, Burke RP. A Randomized Pilot Trial Assessing the Role of Human Fibrinogen Concentrate in Decreasing Cryoprecipitate Use and Blood Loss in Infants Undergoing Cardiopulmonary Bypass. Pediatr Cardiol. 2022 Oct;43(7):1444-1454. doi: 10.1007/s00246-022-02866-4. Epub 2022 Mar 19.

Reference Type DERIVED
PMID: 35305111 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

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https://www.nicklauschildrens.org/home

Nicklaus Children's Hospital

Other Identifiers

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NCH0000201496

Identifier Type: -

Identifier Source: org_study_id

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