Cryoprecipitate for transfusion: which patients receive it and why? A study of patterns of use across three regions in England

Transfus Med. 2012 Oct;22(5):356-61. doi: 10.1111/j.1365-3148.2012.01158.x. Epub 2012 May 14.

Abstract

Background: Despite increasing interest in the use of fibrinogen concentrates, cryoprecipitate remains the major source of fibrinogen in England.

Objectives: Understand patterns and indications for use of cryoprecipitate in hospitals from three English regions.

Method/materials: Data collection over 3 months from adults, children and neonates receiving cryoprecipitate, including clinical scenario, indications, dose and levels of fibrinogen concentrations pre- and post-transfusion.

Results: Four hundred and twenty-three episodes of cryoprecipitate transfusion were analysed from 39 hospitals. Use varied from 0.1 to 4.9 units per 100 red cells transfused. The primary indication was haemorrhage [311 episodes (74%)]. The commonest clinical scenario in all age groups was cardiac surgery, followed by trauma in adults and critical/neonatal care for children. Pre-treatment fibrinogen levels were measured in 322 episodes. In 179 episodes, the level was ≥ 1.0 g L(-1) .

Conclusion: Wide variation in practice and dose suggests inconsistent practice and uncertainty in the evidence informing optimal use of cryoprecipitate.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiac Surgical Procedures*
  • Child
  • Child, Preschool
  • England
  • Factor VIII / analysis
  • Factor VIII / therapeutic use*
  • Female
  • Fibrinogen / analysis*
  • Fibrinogen / metabolism
  • Fibrinogen / therapeutic use
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Practice Patterns, Physicians'*
  • Wounds and Injuries / drug therapy*

Substances

  • cryoprecipitate coagulum
  • Factor VIII
  • Fibrinogen