Prospective, randomized evaluation of the efficacy of fibrin sealant as a topical hemostatic agent at the cannulation site in neonates undergoing extracorporeal membrane oxygenation

James B. Atkinson, Edward D. Gomperts, Robert Kang, Martin Lee, Robert M. Arensman, Robert H. Bartlett, K. Rais-Bharami, Charles W. Breaux, J. Devn Cornish, Gerald M. Haase, Jay Roden, Joseph B. Zwischenberger

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

BACKGROUND: The topical hemostatic effect of fibrin sealant that has been solvent/detergent treated and plasminogen depleted was evaluated in a multicenter prospective, randomized controlled study at the cannulation site wound of infants undergoing extracorporeal membrane oxygenation (ECMO). METHODS: The test group received standard cauterization and Fibrin sealant, while the control group was given cauterization alone to control hemostasis at this site. Efficacy data were available on 173 randomized study subjects of whom 149 met study entry criteria. All were managed according to standard ECMO practice. RESULTS: Fibrin sealant reduced the risk of bleeding, was associated with less shed blood, and was associated with shorter duration of hemorrhage. Further, control infants showed an increased bleeding risk with less depressed fibrinogen levels and prothrombin time elevations >18 seconds prior to ECMO. CONCLUSION: Fibrin sealant is useful as a topical hemostatic agent in patients with coagulopathy not responding to standard surgical techniques.

Original languageEnglish
Pages (from-to)479-484
Number of pages6
JournalAmerican Journal of Surgery
Volume173
Issue number6
DOIs
StatePublished - Jun 1997

Bibliographical note

Funding Information:
Michigan. This research was supported by the Hyland Division, Baxter Healthcare Corporation, and the American Red Cross. We wish to acknowledge the clinical research management role of Gordon Bray, MD, and Lynn Dedrick, RN. Requests for reprints should be addressed to James B. Atkin-son, MD, UCLA Medical Center, 10833 Le Conte Ave., Box 951749, Los Angeles, California 90095-l 749. Manuscript submitted June 11, 1996 and accepted form September 3, 1996.

ASJC Scopus subject areas

  • Surgery

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