Brian Muirhead FRCPC Assistant Professor, University of Manitoba The Efficacy and Cost-effectiveness of Fibrinogen Concentrate (FC) compared to Cryoprecipitate in major bleeding patients Brian Muirhead FRCPC Assistant Professor, University of Manitoba

Objectives Impact of higher threshold levels (1.5 versus 1.0g/L for cardiac and non-obstetrical patient) and 2.5g/L in obstetrical patients Compare the cost of FC and cryo in the vein-to-vein process

Methodology Cardiac and Obstetrical patients to receive 2 – 4gm FC or 10-20 units cryo Non-cardiac, non-obstetrical patients to receive 2gm FC or 10units cryo 40 patients in each group

Data Collection Ave increase Ave TAT Ave rbc post Cryo 0.7 (0.2-1.1) 69 mins* 2.5 units FC 1.3 (0.4-1.7) 23 mins 0.5 units

NOTES In Manitoba, cryo units are thawed by the blood bank, pooling is done by the clinical staff Overwhelming preference by physicians for the fibrinogen concentrate 1 gram FC $399 5 units cryo $550