Cryoprecipitate
Cryoprecipitate (Cryo)
Is prepared from plasma and contains fibrinogen, factor VIII, von Willebrand factor, factor XIII and fibronectin. It is stored frozen and must be transfused within 6 hours of thawing or 4 hours of pooling.
Cryo is indicated for bleeding or immediately prior to an invasive procedure in patients with significant hypofibrinogenemia (<100 mg/dL).
When not to use Cryo:
Cryo should not be used for patients with Hemophilia A (Factor VIII deficiency) unless other recombinant and/or virally inactivated factor VIII preparations are not available. It should not be used for patients with von Willebrand disease unless they are proven not to respond to DDAVP. It is not usually given for Factor XIII deficiency, as there are virus-inactivated concentrates of this protein available. Cryo is sometimes useful if platelet dysfunction associated with renal failure
does not respond to dialysis or DDAVP.
Fibrin-Glue:
Fibrin glue - Although single units of Cryo are available for use in the preparation of fibrin glue to be applied locally for surgery, there are commercially available, virally inactivated concentrates (fibrin sealants) that have a higher fibrinogen concentration
and are preferred for this purpose.
Dosage:
One unit of Cryo is 15-20 mL in volume and contains 150-250 mg of fibrinogen. Cryo is generally transfused in pools of 10 units, which should increase an adult recipient's fibrinogen level by 50-100 mg/dL.
Pediatric dosing for Cyro is 1 unit per 10kg body weight, which should increase fibrinogen by 60-100 mg/dL.
