Manuela Gomes , Hospital da Luz specialist in Immune-hemotherapy, concluded her doctorate degree in Medicine, last April 9, at the Faculty of Medical Sciences / Nova Medical School, Lisbon Nova University. In her thesis – entitled “Fibrinogen concentrate safety for the correction of hypofibrinogenemia in coagulopathic surgical patients” – earned the unanimous approval of the jury with distinction. In her thesis research, Manuela Gomes studied the safety in administering a fibrinogen concentrate to patients presenting blood coagulation problems in the context of previous surgeries. Plasmatic fibrinogen is a determining factor in blood coagulation, after blood vessel damage and the fibrinogen concentrate has the advantage of containing a fixed amount of fibrinogen in a small volume, thus minimizing the need of blood transfusion. However, these advantages of administering fibrinogen concentrate are not yet widely researched and proven, this thesis intending to be a contribution in that sense. The work involved a systematic review with meta-analysis on fibrinogen concentrate safety in adult patients during the perioperative period, and a prospective observational study conducted at Hospital da Luz Lisboa. This observational study involved adults submitted to programmed or emergency surgery and presenting blood coagulation problems, to whom the fibrinogen concentrate was administered. “The results of the meta-analysis and prospective study were aligned, pointing to a potential benefit and favourable safety profile with a low death rate and thromboembolic phenomena” , explains Manuela Gomes. The meta-analysis “was pioneer in this area, since exclusively focused on safety”, which is not the case in other similar studies to date. Main conclusions of research: Age, incidence of previous thromboembolic events, and emergency surgeries are associated with a higher need of blood components transfusion and longer hospitalization periods. Although the use of fibrinogen concentrate does not seem to increase the risk of thromboembolic events, patients requiring higher doses of fibrinogen concentrate were given extra units of erythrocyte concentrate. The lower values of plasmatic fibrinogen in the occurrence of haemorrhage and, consequently, replenishment with fibrinogen concentrate, are also associated to an increased risk, which may indicate – similarly to other situations, namely postpartum haemorrhage – that this a relevant biologic marker to consider in future studies. In the photo above, the new doctor and the jury: António Robalo Nunes (Faculty of Medical Sciences / Nova Medical School – FCM/NMS), Eugénia Martins da Cruz (Abel Salazar Institute of Biomedical Sciences, Oporto University), Fernando Miguel Teixeira Xavier (FCM/NMS and president of the jury), Manuela Gomes, Fernando Ferreira Araújo (Faculty of Medicine, Oporto University, participating by video conference), Jorge Lima (FCM/NMS and thesis advisor), and Susana Mendes Fernandes (Faculty of Medicine, Lisbon University).
