Laura Cooling MD, MS Associate Medical Director Transfusion Medicine Cryoprecipitate Laura Cooling MD, MS Associate Medical Director Transfusion Medicine

Cryoprecipitate Prepared from FFP that is allowed to thaw overnight at 4C. It is literally the “cold” precipitate” of plasma Enriched source of Fibrinogen, VIII, vWF Contains thrombospondin, fibronectin, some IgM 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/dL) 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