Cryoprecipitate

Resources

Requête de produits labiles (ENR-00518) (in French only)

To prepare the cryoprecipitate, the plasma taken in CP2D is thawed between 1°C and 6°C, and the insoluble precipitate is recovered and refrozen. Every cryoprecipitate contains an average of 461 (±153) mg/bag of fibrinogen, factor VIII, factor XIII, and the von Willebrand factor.

Action

The cryoprecipitate is mainly used as a source of fibrinogen and factor XIII.

Main indications

In some cases of massive hemorrhaging, the cryoprecipitate can be used to offset the loss of fibrinogen.

For isolated deficiencies in coagulation factors, if commercial products are not available, this component can be used:

with factor XIII deficiency;
to treat congenital hypofibrinogenemia or dysfibrinogenemia.

Contraindications

The cryoprecipitate should not be used to prepare fibrin glue. Commercial fibrin glues should be used.

Dosage and administration

The product is thawed in a double boiler or a device certified for this purpose. The bags of cryoprecipitate must be placed in an airtight plastic protective sleeve, and the sleeve must be gently shaken. It’s best to limit the number of bags of cryoprecipitate to be thawed at the same time in order to not unduly alter the temperature of the double boiler and have to extend the thawing time. The product must not be used if the container is damaged or if the product was thawed during storage. It must not be refrozen.

There has to be a policy about ABO compatibility of the cryoprecipitates. All recipients can receive a cryoprecipitate transfusion from any ABO group.

Pooling

To prepare the pooling of concentrates, units from different ABO groups can be pooled. This product is reconstituted using 10 to 15 ml of an injectable solution that is 0.9% sodium chloride (USP)

The following rule is used to calculate the required fibrinogen dosage:

recipient’s weight (kg) x 70 ml/kg = volume of blood (ml);
volume of blood (ml) x (1.0 – hematocrit) = volume of plasma (ml);
required amount of fibrinogen in mg = (desired fibrinogen level in mg/dl – initial fibrinogen level in mg/dl) x volume of plasma (ml) ÷ 100 ml/dl;
number of bags of cryoprecipitate required = mg of fibrinogen required ÷ 500 mg of fibrinogen per bag of cryoprecipitate.

Storage

The cryoprecipitate can be stored for 12 months at a temperature less than or equal to −18°C. The cryoprecipitate must be transfused within 24 hours after being thawed. It must be kept between 20°C and 24°C while waiting for it to be administered.