Purpose: The aim of this study was to determine if fibrinogen concentration can be evaluated by dielectric permittivity changes during dielectric blood coagulation testing (DBCM) during cardiovascular surgery with cardiopulmonary bypass (CPB). Methods: We performed a single-center prospective observational study at a university hospital.Prospective observational study. One hundred patients undergoing cardiovascular surgery with CPB were enrolled. Whole-blood samples were obtained after weaning from CPB, and dielectric clot strength (DCS) was measured by intrinsic pathway testing during DBCM. The FIBTEM test was performed during rotational thromboelastometry using the same samples, and maximum clot firmness (MCF) was evaluated. Spearman’s correlation analysis was performed and receiver operating characteristics (ROC) curve analyses were used to evaluate the predictive performance for hypofibrinogenemia. Results: DCS showed a strong positive correlation with plasma fibrinogen concentrations (Rs=0.76, P<0.0001). The area under the ROC curve for predicting plasma fibrinogen concentrations <200 mg/dL was 0.91 (95% confidence interval(CI): 0.85–0.97) for DCS, compared with 0.88 (95% CI: 0.81–0.94) for FIBTEM MCF. The optimal cut-off value of DCS was 17.0 (sensitivity 94%, specificity 80%), Conclusions: DCS variables showed a significant strong correlation with plasma fibrinogen concentrations, and the diagnostic performance for hypofibrinogenemia was comparable with that for FIBTEM MCF. This novel methodology has the potential to provide a point-of-care test with sufficient predictive accuracy for perioperative hypofibrinogenemia during cardiovascular surgery with CPB.
