Callum J, Farkouh ME, Scales DC, et al. - Researchers examined the efficacy of fibrinogen concentrate vs cryoprecipitate in the treatment of bleeding related to acquired hypofibrinogenemia in cardiac surgery. They conducted a randomized trial at 11 Canadian hospitals recruiting 735 adult patients experiencing clinically significant bleeding and hypofibrinogenemia after cardiac surgery (from February 10, 2017, to November 1, 2018). The patients were assigned to receive fibrinogen concentrate (4 g; n = 415) or cryoprecipitate (10 units; n = 412) for each ordered dose within 24 hours after cardiopulmonary bypass. In the fibrinogen concentrate group, the mean number of blood components transfused within 24 hours post bypass was 16.3 units vs 17.0 units transfused in the cryoprecipitate group. The ratio of the mean number of units transfused was 0.96, which fitted the prespecified noninferiority margin ratio of less than 1.2. These findings suggest that consideration could be given to fibrinogen concentrate for fibrinogen replacement for management of cardiac surgery-associated bleeding related to acquired hypofibrinogenemia.