Cryoprecipitate Laura Cooling MD MS Associate Medical Director

Cryoprecipitate • Prepared from FFP that is allowed to thaw overnight at 4 C.

Cryoprecipitate Each unit • 7 -15 cc total volume • 250 mg fibrinogen •

Indications for Cryoprecipitate • Hypofibrinogenemia (<100 mg/d. L) and bleeding/prior to surgery • Dysfibrinogenemia

Common Mistakes Inadequate dose • order 1 unit (10 cc) for adult Inappropriate Administration

Cryoprecipitate Administration • ABO compatible preferred but not required • Infused within 4 hrs

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Cryoprecipitate Laura Cooling MD, MS Associate Medical Director Transfusion Medicine

Cryoprecipitate • Prepared from FFP that is allowed to thaw overnight at 4 C. It is literally the “cold” precipitate” of plasma • Enriched source of Fibrinogen, VIII, v. WF • Contains thrombospondin, fibronectin, some Ig. M antibodies

Cryoprecipitate Each unit • 7 -15 cc total volume • 250 mg fibrinogen • 80 -120 U VIII Adult: Pool several units (avg 10) for adults

Indications for Cryoprecipitate • Hypofibrinogenemia (<100 mg/d. L) and bleeding/prior to surgery • Dysfibrinogenemia and bleeding/prior to surgery • Factor XIII deficiency • Fibrin patch-Oto, cardiothoracic, dental • Uremic bleeding Less Common Now (better alternatives) • von Willebrand Disease, VIII deficiency

Common Mistakes Inadequate dose • order 1 unit (10 cc) for adult Inappropriate Administration • Patient with volume overload and Multifactor deficiency (long PT/PTT) Over-ordering/ Over transfusion • Surgery responsible for 65% cryo waste

Cryoprecipitate Administration • ABO compatible preferred but not required • Infused within 4 hrs of thaw, pooling Dose: 10 pooled (adult) 1 unit/5 kg (infants/children) Rate: Like FFP (200 -250 cc/20 -30 min) Efficacy: Increase fibrinogen 5 mg/dl /unit 10 units=raise fibrinogen 50 mg/dl