Target Audience
This activity has been designed to meet the educational needs of surgeons, anesthesiologists, OR specialists, ER team members, hematologists, trauma specialists, blood bankers, and other clinicians interested in blood factor disorders that may cause complications during surgical procedures and trauma.



Statement of Need
Uncontrolled bleeding is routinely encountered in the surgical or trauma scenario. Fibrinogen, essential for the formation of a fibrin clot, is often implicated as a fundamental risk factor for bleeding when decreased concentration or altered function of the clotting factor arises as the consequence of congenital or acquired fibrinogen disorders. This learning activity is designed to provide clinicians with the latest information on the role of plasma fibrinogen in perioperative hemostasis and provide expert opinion on current and emerging strategies for maintaining optimal fibrinogen levels in cardiac surgery.



Educational Objectives
After completing this activity, the participant should be better able to:

• Explain the role of fibrinogen in clot formation and its significance to the management of perioperative bleeding
• Compare the advantages and disadvantages of fresh frozen plasma and cryoprecipitate as therapeutic modalities for increasing fibrinogen level and restoring hemostasis in surgical and trauma patients
• Discuss current and emerging treatment approaches for managing perioperative bleeding due to fibrinogen deficiency in cardiac surgery patients

Distinguished Faculty
Aryeh Shander, MD, FCCM, FCCP
Chief Executive Medical Director
Department of Anesthesiology, Critical Care Medicine, Pain Management,
and Hyperbaric Medicine
Englewood Hospital and Medical Center
Englewood, New Jersey
Clinical Professor of Anesthesiology, Medicine, and Surgery
Mount Sinai School of Medicine
Mount Sinai Hospital
New York, New York



Physician Continuing Medical Education
Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM), the Cardiovascular & Metabolic Health Foundation, and Educational Concepts in Medicine. PIM is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation
Postgraduate Institute for Medicine designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.


Method of Participation
During the period February 26, 2010 through February 26, 2011, participants must:

• Read the learning objectives and faculty disclosures
• Study the educational activity
• Complete the posttest by recording the best answer to each question
• Complete the evaluation form

A statement of credit will be issued upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better.


Fee
There is no fee to participate in or to receive credit for this educational activity.


Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers, and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high-quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Name of Faculty or Presenter

Reported Financial Relationship

Aryeh Shander, MD, FCCM, FCCP

Consulting Fees: Bayer HealthCare Pharmaceuticals, Luitpold Pharmaceuticals, Inc., Masimo Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk Pharmaceuticals, Ortho Biotech Products, L.P., ZymoGenetics, Inc. Fees for Non-CME Services Received Directly From a Commercial Interest or Their Agents: Bayer HealthCare Pharmaceuticals, Masimo Corporation, Novartis Pharmaceuticals Corporation, Ortho Biotech Products, L.P., ZymoGenetics, Inc. Contracted Research: Bayer HealthCare Pharmaceuticals, Novartis Pharmaceuticals Corporation, Novo Nordisk Pharmaceuticals, Ortho Biotech Products, L.P., Pfizer Inc., ZymoGenetics, Inc

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Name of Planner or Manager	Reported Financial Relationship
PIM Clinical Reviewers: Trace Hutchison, PharmD; Jan Hixon, RN, BSN, MA; Jan Schultz, RN, MSN, CCMEP; and Julia Kirkwood, RN, BSN	Have no real or apparent conflicts of interest to report.
ECM: Patrick J. Crowley, Senior Director, Operations; Jodi Andrews, Foundation Manager; Gay Boyle, Editorial Services; Kathleen Casey Krafton, Editorial Services	Have no real or apparent conflicts of interest to report.

Media
Internet


Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Postgraduate Institute for Medicine (PIM), Cardiovascular & Metabolic Health Foundation (CMH), Educational Concepts in Medicine (ECM), and CSL Behring do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, CMH, ECM, and CSL Behring. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients' conditions and possible contraindications on dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.


Commercial Support
This activity is supported by an educational grant from CSL Behring.