Data set from Ranucci M, Bianchi P, Cotza M, Beccaris C, Silvetti S, Isgrò G, Giamberti A, Baryshnikova E. Fibrinogen levels and postoperative chest drain blood loss in low-weight (<10 kg) children undergoing cardiac surgery. Perfusion. 2019 Nov;34(8):629-636. doi: 10.1177/0267659119854246. Epub 2019 Jun 28. PMID: 31250738.

Data set from Ranucci M, Bianchi P, Cotza M, Beccaris C, Silvetti S, Isgrò G, Giamberti A, Baryshnikova E. Fibrinogen levels and postoperative chest drain blood loss in low-weight (&lt;10 kg) children undergoing cardiac surgery. Perfusion. 2019 Nov;34(8):629-636. doi: 10.1177/0267659119854246. Epub 2019 Jun 28. PMID: 31250738. This is the abstract: <strong>Introduction: </strong> Low-weight (&lt;10 kg) children undergoing cardiac surgery with cardiopulmonary bypass are prone to dilution and consumption of soluble coagulation factors and fibrinogen. Low levels of fibrinogen may represent a possible cause of severe postoperative chest drain blood loss. The present study investigates the association between post-cardiopulmonary bypass fibrinogen levels and postoperative chest drain blood loss and severe bleeding, aiming to identify possible cut-off values to trigger specific interventions. <strong>Methods: </strong> Prospective cohort study on 77 patients weighing &lt;10 kg undergoing cardiac surgery with cardiopulmonary bypass. Haemostasis and coagulation data were collected before surgery (standard tests and thromboelastometry), after protamine (thromboelastometry) and at the arrival in the intensive care unit (standard tests). The primary outcome variable was severe bleeding (chest drain blood loss &gt;30 ml kg^-1/24h). <strong>Results: </strong> Factors being independently associated with severe bleeding were the international normalized ratio and the fibrinogen levels at the arrival in the intensive care unit. Once corrected for other confounders, fibrinogen levels had an odds ratio of 0.2 (95% confidence interval = 0.011-0.54) per 1 gL^-1 for severe bleeding. The discrimination power was fair (area under the curve = 0.770). The best cut-off value was identified at a fibrinogen level of 150 mg dL^-1, with a sensitivity of 52%, a specificity of 85% and a positive predictive value of 60% for severe bleeding. <strong>Conclusion: </strong> Both a prolonged international normalized ratio and low fibrinogen levels were predictive for severe bleeding, underscoring the role of coagulation factors dilution and consumption in this specific patient population.本数据集源自Ranucci M、Bianchi P、Cotza M、Beccaris C、Silvetti S、Isgrò G、Giamberti A、Baryshnikova E的研究论文：《体重<10kg的心脏手术患儿纤维蛋白原（fibrinogen）水平与术后胸腔引流出血量的关联》，刊载于*Perfusion*期刊，2019年11月；34(8):629-636。DOI: 10.1177/0267659119854246，2019年6月28日在线发表，PMID: 31250738。 **研究背景**：接受体外循环（cardiopulmonary bypass）下心脏手术的体重<10kg儿童，易出现可溶性凝血因子及纤维蛋白原的稀释与消耗。低纤维蛋白原水平可能是术后严重胸腔引流出血的潜在诱因。本研究旨在探讨体外循环术后纤维蛋白原水平与术后胸腔引流出血量及严重出血事件的关联，以期明确可触发针对性干预的临界值。 **研究方法**：本研究为前瞻性队列研究，纳入77例体重<10kg、接受体外循环下心脏手术的患儿。分别于术前（常规凝血检测及血栓弹性描记法（thromboelastometry））、鱼精蛋白（protamine）中和后（血栓弹性描记法）及转入重症监护病房（ICU）时（常规凝血检测）采集止血与凝血相关数据。本研究的主要结局指标为严重出血事件（术后24小时胸腔引流出血量>30 ml·kg⁻¹）。 **研究结果**：转入ICU时的国际标准化比值（international normalized ratio, INR）与纤维蛋白原水平是严重出血事件的独立相关因素。校正其他混杂因素后，纤维蛋白原水平每升高1 g·L⁻¹，严重出血的优势比（odds ratio）为0.2（95%置信区间（confidence interval）：0.011~0.54）。模型的区分度尚可（曲线下面积（area under the curve）=0.770）。最佳临界值确定为150 mg·dL⁻¹，此时对严重出血的灵敏度（sensitivity）为52%，特异度（specificity）为85%，阳性预测值（positive predictive value）为60%。 **研究结论**：国际标准化比值延长与低纤维蛋白原水平均可作为严重出血事件的预测因素，这一结果凸显了凝血因子稀释与消耗在该特定患者群体中的作用。