Cryoprecipitate is prepared by slow-thawing frozen plasma at 4°C, which leaves a cold-insoluble precipitate, mainly consisting of plasma proteins harvested by centrifugation. At least 10 single bags of cryoprecipitate are needed for one adult dose of fibrinogen.1
The main components of cryoprecipitate are coagulation factors VIII and XIII, von Willebrand factor, fibronectin, and fibrinogen. 1 Typical units of cryoprecipitate contain 70 IU/ml factor VIII and are rich in fibrinogen. 1 Cryoprecipitate is indicated for bleeding associated with:
- Hypofibrinogenemia (i.e. a fibrinogen level of < 0.75 g/l)
- Von Willebrand disease
- Hemophilia, if factor VIII is not available
A typical dose of cryoprecipitate (10 units, each containing 140 mg to 360 mg of fibrinogen) raises the plasma fibrinogen level by about 1g/liter. ABO blood group compatibility is preferred – but not essential – for transfusion of cryoprecipitate.11 Cryoprecipitate is typically used in perioperative bleeding when standard transfusion therapy (e.g. RBCs, fresh frozen plasma and platelets) fails to correct a coagulopathy, or if a fibrinogen deficiency has been identified, either by laboratory or point-of-care testing.
Cryoprecipitate has commonly been used as a replacement for fibrinogen.16 Cryoprecipitate contains a higher concentration of fibrinogen than fresh frozen plasma.17
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