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Vol 11, No 1 (2018)
Research paper
Published online: 2018-04-26

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Evaluation of Clinical Appropriateness of Cryoprecipitate transfusion

Manish Raturi1, Shamee Shastry1, Mohandoss Murugesan2, Pruthvi Raj1, Poornima Baliga B1
Journal of Transfusion Medicine 2018;11(1):1-7.


Background. Cryoprecipitate (CRYO) is mainly used for management of hypofibrinogenemia during hemorrhage. The historical 1.0 g L−1 threshold of fibrinogen is considered quite inadequate, especially in massive bleeds. Furthermore, the appropriate dose and its impact on plasma fibrinogen levels are unclear. Our aim was to evaluate the appropriateness of CRYO transfusion at our hospital. Material and methods. Retrospective review of indicators namely indications, dosage, pre- -transfusion coagulation parameters and the magnitude of mean plasma fibrinogen increase (Fibinc) to CRYO transfusion were undertaken at a multi-specialty hospital. Appropriateness was defined based on compliance to both national and international guidelines. Results. A total of 400 transfusions were given in 253 patients. Commonest primary indication was hemorrhage (86%) against prophylaxis (14%). Conventionally commonest clinical scenarios were disseminated intravascular coagulation in hemato-oncology [110 episodes (28%)] followed by factor VIII deficiency [92 episodes (23%)] and cardiac surgery [52 episodes (13%)] respectively. Based on indications the overall appropriateness was 92.5%. Pre-transfusion fibrinogen levels were available in 66% (264/400) episodes including 204 events having fibrinogen < 1.0 g L-1. In patients who did not receive plasma components 6 h prior to CRYO, a mean dose of 6.2 units caused a Fibinc of 0.54 (± 0.36) g L−1. Conclusion: The overall Fibinc per unit of CRYO transfused was 0.09 g L-1. We have noted high level of appropriateness towards CRYO transfusion (92.5%) in the present study.

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  1. Dumont LJ, Papari M, Aronson CA, et al. Whole-blood collection and component processing. In: Fung MK, Grossman BJ, Hillyer CD, et al., editors. Technical manual. 18th ed. Bethesda (MD): American Association of Blood Banks; 2014. p. 148-54.
  2. Saran RK. Blood Transfusion Safety and Regulatory Requirements. In: Transfusion medicine Technical Manual, 2nd ed. New Delhi: DGHS, Ministry of Health and Family Welfare; 2003. p. : 222.
  3. Stehling LC, Doherty DC, Faust RJ, et al. Practice guidelines for blood component therapy: a report by the American Society of Anesthesiologists Task Force on Blood Component Therapy. Anesthesiology. 1996; 84: 732–47.
  4. O'Shaughnessy DF, Atterbury C, Bolton Maggs P, et al. British Committee for Standards in Haematology, Blood Transfusion Task Force. Guidelines for the use of fresh-frozen plasma, cryoprecipitate and cryosupernatant. Br J Haematol. 2004; 126(1): 11–28.
  5. Pantanowitz L, Kruskall MS, Uhl L. Cryoprecipitate. Patterns of use. Am J Clin Pathol. 2003; 119(6): 874–881.
  6. Schofield WN, Rubin GL, Dean MG. Appropriateness of platelet, fresh frozen plasma and cryoprecipitate transfusion in New South Wales public hospitals. Med J Aust. 2003; 178(3): 117–121.
  7. Nascimento B, Rizoli S, Rubenfeld G, et al. Cryoprecipitate transfusion: assessing appropriateness and dosing in trauma. Transfus Med. 2011; 21(6): 394–401.
  8. Ranucci, M., Pistuddi, V., Baryshnikova, E., Colella, D., Bianchi, P. Fibrinogen Levels after Cardiac Surgical Procedures: Association with Postoperative Bleeding, Trigger Values, and Target Values Annals of Thoracic Surgery, 102 (1), pp. 2016: 78–85.
  9. Rossaint R, Cerny V, Coats TJ, et al. Key issues in advanced bleeding care in trauma. Shock. 2006; 26(4): 322–331.
  10. Alport EC, Callum JL, Nahirniak S, et al. Cryoprecipitate use in 25 Canadian hospitals: commonly used outside of the published guidelines. Transfusion. 2008; 48(10): 2122–2127.