Cryoprecipitate: Patterns of use

The type of coagulation factors and proteins in cryoprecipitate determine the appropriate indications for its use. To determine the pattern of use at a tertiary care medical center, we performed a retrospective audit of cryoprecipitate utilization. A total of 51 patients received 88 pools of cryopre...

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Bibliographic Details
Published in:American journal of clinical pathology 2003-06, Vol.119 (6), p.874-881
Main Authors: PANTANOWITZ, Liron, KRUSKALL, Margot S, UHL, Lynne
Format: Article
Language:English
Subjects:
Adult
Afibrinogenemia - drug therapy
Aged
Aged, 80 and over
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Blood Loss, Surgical - prevention & control
Blood Transfusion
Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis
Factor VIII - therapeutic use
Fibrin Tissue Adhesive - therapeutic use
Fibrinogen - therapeutic use
Hemorrhage - drug therapy
Hemorrhage - etiology
Humans
Liver Neoplasms - complications
Medical Audit
Medical sciences
Middle Aged
Retrospective Studies
Tissue Plasminogen Activator - adverse effects
Transfusions. Complications. Transfusion reactions. Cell and gene therapy
Uremia - complications
Warfarin - adverse effects
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Summary:The type of coagulation factors and proteins in cryoprecipitate determine the appropriate indications for its use. To determine the pattern of use at a tertiary care medical center, we performed a retrospective audit of cryoprecipitate utilization. A total of 51 patients received 88 pools of cryoprecipitate. In 39 patients, cryoprecipitate was transfused for appropriate indications: hypofibrinogenemia (n = 19), tissue plasminogen activator reversal (n = 1), management of massive transfusion (n = 7), correction of uremic bleeding (n = 2), and for making fibrin sealant (n = 10). Overall, these patients used approximately 80% of the cryoprecipitate transfused. In 12 other patients, cryoprecipitate was transfused inappropriately to attempt reversal of the anticoagulant effects of warfarin therapy (n = 6), to treat impaired surgical hemostasis in the absence of hypofibrinogenemia (n = 4), and to treat hepatic coagulopathy with multiple factor deficiencies (n = 2). The patterns of misuse, involving 24% of all cryoprecipitate orders, suggest a widespread misunderstanding and need for focused education about the coagulation factors and proteins present in cryoprecipitate and appropriate indications for its use.
ISSN:0002-9173
1943-7722
DOI:10.1309/56MQVQAQG8YU90X9