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CompletedNCT02822599RiaSTAPUpdated Sep 16, 2021Results posted

Human Fibrinogen Concentrate in Pediatric Cardiac Surgery

A Phase 4 interventional study of RiaStAP and Saline in Hypofibrinogenemia, Afibrinogenemia and Bleeding Disorders, sponsored by Nicklaus Children's Hospital f/k/a Miami Children's Hospital. Completed at 2 sites in United States. Open to participants aged 1 Day to 1 Year. Per ClinicalTrials.gov, last updated 2021-09-16.

Sponsored by Nicklaus Children's Hospital f/k/a Miami Children's Hospital · Phase 4, Interventional, and Prevention

Phase
Phase 4
Study type
Interventional
Enrollment
30
Allocation
Randomized
Ages
1 Day to 1 Year
Sex
All
01

Study summary

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.

Read the detailed description

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.

02

Conditions studied

  • Hypofibrinogenemia
  • Afibrinogenemia
  • Bleeding Disorders

Keywords

  • CBP, congenital heart defects, cardiopulmonary bypass
03

In context

Hemostatic Disorders

503 studies on the registry are indexed under Hemostatic Disorders; 71 are open to participants now.

This study's enrollment of 30 is below the median of 51 across 253 interventional studies indexed under Hemostatic Disorders.

Browse Hemostatic Disorders studies →

Lead sponsor

Nicklaus Children's Hospital f/k/a Miami Children's Hospital is the lead sponsor of 12 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
1 Day to 1 Year
Sexes eligible
All
Accepts healthy volunteers
No

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

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.
05

Study design

Phase
Phase 4
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
30 participants (actual)

Study arms

  • Active comparator
    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.

    Drug: RiaStAP

  • Placebo comparator
    Saline

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

    Drug: Saline

Interventions

  • DrugRiaStAP

    To decrease post-operative bleeding volume.

    Also known as: Fibrinogen Concentrate Human

  • DrugSaline

    Placebo consisting of normal saline 0.9%

    Also known as: Normal Saline 0.9%

06

What researchers measure

Primary outcomes

  1. Postoperative Blood Loss After Surgery (Estimated Blood Loss (EBL))

    Primary outcome efficacy: Estimated blood loss (EBL); median; A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Thereafter, as per routine care, ROTEM analysis was performed at least every 30 minutes while in the OR, or sooner, at the discretion of the OR team. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analysis algorithm.

    Time frame: Within 24 hours of surgery

  2. Post-operative 2 hr Hemoglobin (Hg) mg/dL Measure

    Post-operative 2 hr hemoglobin (Hg) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Thereafter, as per routine care, ROTEM analysis was performed at least every 30 minutes while in the OR, or sooner, at the discretion of the OR team. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analysis algorithm.

    Time frame: 2 hour

  3. Post-operative 24-hr Hemoglobin (Hg) mg/dL

    Post-operative 24-hr hemoglobin (Hg) between treatment and placebo. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Thereafter, as per routine care, ROTEM analysis was performed at least every 30 minutes while in the OR, or sooner, at the discretion of the OR team. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analysis algorithm.

    Time frame: 24 hr

  4. Post-operative 2 hr Hematocrit (HCT) Measure

    Post-operative 2 hr Hematocrit (HCT) between the treatment and placebo group.

    Time frame: 2 hour

  5. Post-operative 24 hr Hematocrit (HCT) Measure

    Post-operative 24 hr Hematocrit (HCT) between the treatment and placebo group

    Time frame: 24 hour

  6. Post-operative 2 hr Platelets Count Test (PLT) 10K/uL

    Post-operative 2 hr Platelets Count Test (PLT) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analysis algor

    Time frame: 2 hour

  7. Post-operative 24 hr Platelets Count Test (PLT) 10K/uL

    Post-operative 24 hr Platelets Count Test (PLT) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analysis algo

    Time frame: 24 hour

  8. Post-operative 2 hr Prothrombin (PT) Seconds

    Post-operative 2 hr Prothrombin (PT) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Thereafter, as per routine care, ROTEM analysis was performed at least every 30 minutes while in the OR, or sooner, at the discretion of the OR team. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analysis algorithm.

    Time frame: 2 hour

  9. Post-operative 24 hr Prothrombin (PT) Seconds

    Post-operative 24 hr Prothrombin (PT) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Thereafter, as per routine care, ROTEM analysis was performed at least every 30 minutes while in the OR, or sooner, at the discretion of the OR team. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analysis algorithm.

    Time frame: 24 hour

  10. Post-operative 2 hr International Normalize Ratio (INR)

    Post-operative 2 hr International Normalize Ratio (INR) between the treatment and placebo group

    Time frame: 2 hour

  11. Post-operative 24 hr International Normalize Ratio (INR)

    Post-operative 24 hr International Normalize Ratio (INR) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM ana

    Time frame: 24 hour

  12. Post-operative 2 hr Partial Thromboplastin Time (PTT) Seconds

    Post-operative 2 hr Partial Thromboplastin Time (PTT) between the treatment and placebo group

    Time frame: 2 hour

  13. Post-operative 24 hr Partial Thromboplastin Time (PTT) Seconds

    Post-operative 24 hr Partial Thromboplastin Time (PTT) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analys

    Time frame: 24 hour

  14. Post-operative 2 hr Fibrinogen mg/dL

    Post-operative 2 hr Fibrinogen between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Thereafter, as per routine care, ROTEM analysis was performed at least every 30 minutes while in the OR, or sooner, at the discretion of the OR team. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analysis algorithm.

    Time frame: 2 hour

  15. Post-operative 24 hr Fibrinogen mg/dL

    Post-operative 24 hr Fibrinogen between the treatment and placebo group

    Time frame: 24 hour

Secondary outcomes

  1. Post-Operative Respiratory Failure Adverse Events

    Patients who suffered from respiratory failure post operatively.

    Time frame: 24 hours after surgery

  2. Post-operative Thrombus Adverse Events

    Patient who suffered from Thrombus events post-operatively.

    Time frame: within 24 hours of surgery

07

Results

Posted Sep 16, 2021

Participant flow

Participant flow — Overall Study
MilestoneRiaSTAPSaline
Started1515
Completed1515
Not completed00

Outcome measures

PrimaryPostoperative Blood Loss After Surgery (Estimated Blood Loss (EBL))

Primary outcome efficacy: Estimated blood loss (EBL); median; A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Thereafter, as per routine care, ROTEM analysis was performed at least every 30 minutes while in the OR, or sooner, at the discretion of the OR team. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analysis algorithm.

Time frame:
Within 24 hours of surgery
Reported as:
Median · cc/kg
Postoperative Blood Loss After Surgery (Estimated Blood Loss (EBL))
cc/kgRiaSTAPSaline
Postoperative Blood Loss After Surgery (Estimated Blood Loss (EBL))35 (21 to 61)33 (26 to 48)
PrimaryPost-operative 2 hr Hemoglobin (Hg) mg/dL Measure

Post-operative 2 hr hemoglobin (Hg) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Thereafter, as per routine care, ROTEM analysis was performed at least every 30 minutes while in the OR, or sooner, at the discretion of the OR team. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analysis algorithm.

Time frame:
2 hour
Reported as:
Median · mg/dL
Post-operative 2 hr Hemoglobin (Hg) mg/dL Measure
mg/dLRiaSTAPSaline
Post-operative 2 hr Hemoglobin (Hg) mg/dL Measure13.6 (11.0 to 15.2)12.5 (11.7 to 13.3)
PrimaryPost-operative 24-hr Hemoglobin (Hg) mg/dL

Post-operative 24-hr hemoglobin (Hg) between treatment and placebo. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Thereafter, as per routine care, ROTEM analysis was performed at least every 30 minutes while in the OR, or sooner, at the discretion of the OR team. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analysis algorithm.

Time frame:
24 hr
Reported as:
Median · mg/dL
Post-operative 24-hr Hemoglobin (Hg) mg/dL
mg/dLRiaSTAPSaline
Post-operative 24-hr Hemoglobin (Hg) mg/dL13.8 (11.7 to 15.8)12.4 (11.0 to 14.7)
PrimaryPost-operative 2 hr Hematocrit (HCT) Measure

Post-operative 2 hr Hematocrit (HCT) between the treatment and placebo group.

Time frame:
2 hour
Reported as:
Median · percent of hematocrit
Post-operative 2 hr Hematocrit (HCT) Measure
percent of hematocritRiaSTAPSaline
Post-operative 2 hr Hematocrit (HCT) Measure40.9 (32.7 to 43.5)35.9 (35.4 to 38.8)
PrimaryPost-operative 24 hr Hematocrit (HCT) Measure

Post-operative 24 hr Hematocrit (HCT) between the treatment and placebo group

Time frame:
24 hour
Reported as:
Median · percent
Post-operative 24 hr Hematocrit (HCT) Measure
percentRiaSTAPSaline
Post-operative 24 hr Hematocrit (HCT) Measure38.9 (34.1 to 45.3)35.4 (32.9 to 42.8)
PrimaryPost-operative 2 hr Platelets Count Test (PLT) 10K/uL

Post-operative 2 hr Platelets Count Test (PLT) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analysis algor

Time frame:
2 hour
Reported as:
Median · 10x10^3 platelets/uL
Post-operative 2 hr Platelets Count Test (PLT) 10K/uL
10x10^3 platelets/uLRiaSTAPSaline
Post-operative 2 hr Platelets Count Test (PLT) 10K/uL282.0 (234.0 to 309.0)224.0 (192.0 to 311.0)
PrimaryPost-operative 24 hr Platelets Count Test (PLT) 10K/uL

Post-operative 24 hr Platelets Count Test (PLT) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analysis algo

Time frame:
24 hour
Reported as:
Median · 10x10^3 platelets/uL
Post-operative 24 hr Platelets Count Test (PLT) 10K/uL
10x10^3 platelets/uLRiaSTAPSaline
Post-operative 24 hr Platelets Count Test (PLT) 10K/uL249.0 (197.0 to 297.0)247.0 (189.0 to 300.0)
PrimaryPost-operative 2 hr Prothrombin (PT) Seconds

Post-operative 2 hr Prothrombin (PT) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Thereafter, as per routine care, ROTEM analysis was performed at least every 30 minutes while in the OR, or sooner, at the discretion of the OR team. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analysis algorithm.

Time frame:
2 hour
Reported as:
Median · seconds
Post-operative 2 hr Prothrombin (PT) Seconds
secondsRiaSTAPSaline
Post-operative 2 hr Prothrombin (PT) Seconds17.0 (16.7 to 18.5)16.5 (15.8 to 17.2)
PrimaryPost-operative 24 hr Prothrombin (PT) Seconds

Post-operative 24 hr Prothrombin (PT) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Thereafter, as per routine care, ROTEM analysis was performed at least every 30 minutes while in the OR, or sooner, at the discretion of the OR team. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analysis algorithm.

Time frame:
24 hour
Reported as:
Median · seconds
Post-operative 24 hr Prothrombin (PT) Seconds
secondsRiaSTAPSaline
Post-operative 24 hr Prothrombin (PT) Seconds16.0 (15.4 to 18.2)16.1 (14.9 to 17.1)
PrimaryPost-operative 2 hr International Normalize Ratio (INR)

Post-operative 2 hr International Normalize Ratio (INR) between the treatment and placebo group

Time frame:
2 hour
Reported as:
Median · ratio
Post-operative 2 hr International Normalize Ratio (INR)
ratioRiaSTAPSaline
Post-operative 2 hr International Normalize Ratio (INR)1.4 (1.3 to 1.5)1.4 (1.2 to 1.4)
PrimaryPost-operative 24 hr International Normalize Ratio (INR)

Post-operative 24 hr International Normalize Ratio (INR) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM ana

Time frame:
24 hour
Reported as:
Median · ratio
Post-operative 24 hr International Normalize Ratio (INR)
ratioRiaSTAPSaline
Post-operative 24 hr International Normalize Ratio (INR)1.3 (1.2 to 1.5)1.3 (1.2 to 1.4)
PrimaryPost-operative 2 hr Partial Thromboplastin Time (PTT) Seconds

Post-operative 2 hr Partial Thromboplastin Time (PTT) between the treatment and placebo group

Time frame:
2 hour
Reported as:
Median · seconds
Post-operative 2 hr Partial Thromboplastin Time (PTT) Seconds
secondsRiaSTAPSaline
Post-operative 2 hr Partial Thromboplastin Time (PTT) Seconds36.7 (33.7 to 41.1)35.2 (32.1 to 36.6)
PrimaryPost-operative 24 hr Partial Thromboplastin Time (PTT) Seconds

Post-operative 24 hr Partial Thromboplastin Time (PTT) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analys

Time frame:
24 hour
Reported as:
Median · seconds
Post-operative 24 hr Partial Thromboplastin Time (PTT) Seconds
secondsRiaSTAPSaline
Post-operative 24 hr Partial Thromboplastin Time (PTT) Seconds35.5 (34.1 to 38.6)31.5 (30.3 to 35.5)
PrimaryPost-operative 2 hr Fibrinogen mg/dL

Post-operative 2 hr Fibrinogen between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Thereafter, as per routine care, ROTEM analysis was performed at least every 30 minutes while in the OR, or sooner, at the discretion of the OR team. Once the patient left the OR, ROTEM was performed at least every 60 minutes for the first 6 hours or until clinically significant bleeding had stopped. Blood products transfused after CPB separation were based on a pre-defined protocol. Recommended volumes of each therapy were based on pre-defined formulae and a ROTEM analysis algorithm.

Time frame:
2 hour
Reported as:
Median · mg/dL
Post-operative 2 hr Fibrinogen mg/dL
mg/dLRiaSTAPSaline
Post-operative 2 hr Fibrinogen mg/dL258.0 (238.0 to 338.0)330.0 (281.0 to 385.0)
PrimaryPost-operative 24 hr Fibrinogen mg/dL

Post-operative 24 hr Fibrinogen between the treatment and placebo group

Time frame:
24 hour
Reported as:
Median · mg/dL
Post-operative 24 hr Fibrinogen mg/dL
mg/dLRiaSTAPSaline
Post-operative 24 hr Fibrinogen mg/dL416.5 (318.5 to 512.0)403.0 (324.0 to 465.0)
SecondaryPost-Operative Respiratory Failure Adverse Events

Patients who suffered from respiratory failure post operatively.

Time frame:
24 hours after surgery
Reported as:
Number · participants
Post-Operative Respiratory Failure Adverse Events
participantsRiaSTAPSaline
Post-Operative Respiratory Failure Adverse Events33
SecondaryPost-operative Thrombus Adverse Events

Patient who suffered from Thrombus events post-operatively.

Time frame:
within 24 hours of surgery
Reported as:
Number · participants
Post-operative Thrombus Adverse Events
participantsRiaSTAPSaline
Post-operative Thrombus Adverse Events42

Adverse events

Collected over 24 hours after surgery;. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
RiaStap0/15 (0%)7/15 (46.7%)—
Placebo0/15 (0%)5/15 (33.3%)—
Most frequent serious events
Most frequent serious events
EventRiaStapPlacebo
ThrombusCardiac disorders4/152/15
Acute Respiratory FailureRespiratory, thoracic and mediastinal disorders3/153/15

Baseline characteristics

Baseline is 15 in RiaSTAP and 15 in Saline solution.

Age, Categorical
Age, Categorical(Participants)RiaSTAPSalineTotal
<=18 years151530
Between 18 and 65 years000
>=65 years000
Sex: Female, Male
Sex: Female, Male(Participants)RiaSTAPSalineTotal
Female6713
Male9817
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)RiaSTAPSalineTotal
Race — Mixed Race202
Race — Black/African American325
Race — White101323
Region of Enrollment
Region of Enrollment(participants)RiaSTAPSalineTotal
United States151530
08

Study locations

2 sites
  • Nickalus Children's Hospital f/k/a Miami Children's Hospital
    Miami, Florida 33155, United States
  • Nicklaus Children's Hospital
    Miami, Florida 33155, United States
09

References and documents

Publications

  • 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. PubMed 9565127 ↗
  • 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. PubMed 8622301 ↗
  • 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. PubMed 15278267 ↗
  • 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. PubMed 15502028 ↗
  • 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. PubMed 1510523 ↗
  • 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. Erratum In: Thromb Haemost 1997 May;77(5):1047. PubMed 9157580 ↗
  • 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. PubMed 18657083 ↗
  • 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. PubMed 19572078 ↗
  • 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. PubMed 19411671 ↗
  • 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. PubMed 35305111 ↗

Study documents

  • Protocol and statistical analysis plan · Dec 7, 2017

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 16, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02822599
Lead sponsor
Nicklaus Children's Hospital f/k/a Miami Children's Hospital
Responsible party
Christopher Tirotta, MD, MBA (Director Cardiac Anesthesia, Nicklaus Children's Hospital f/k/a Miami Children's Hospital) — Principal investigator
First posted
Jul 4, 2016
Start date
Jun 1, 2017
Primary completion
Aug 26, 2019
Completion
Dec 24, 2020
Results posted
Sep 16, 2021
Last update
Sep 16, 2021

Study contacts

Christopher Tirotta, MD
principal investigator · Director Cardiac Anesthesia

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

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