Effects and issues of in-hospital preparation of cryoprecipitates

Abstract

Cryoprecipitates contain high concentrations of coagulation factors such as fibrinogen. Hence, a cryoprecipitate infusion for massive bleeding may reduce blood loss and blood transfusion requirement. We introduced processes for the supply of in-hospital-prepared cryoprecipitates and found changes in transfusion-related clinical parameters in our hospital. In this study, we compared the use and non-use of cryoprecipitates in major and nonmajor cardiovascular surgeries. The parameters compared were the amounts of blood loss, red blood cells (RBC), fresh frozen plasma (FFP), and platelet concentrate administered, the ratio of RBC to FFP (R/F ratio), and the duration of intensive care unit admission. The levels of serum fibrinogen increased after cryoprecipitate infusion. However, the amount of blood loss was greater in use than non-use of cryoprecipitates for both major and nonmajor cardiovascular surgeries. There was no significant differences in RBC and FFP administered for patients use and non-use cryoprecipitates for major cardiovascular surgery. Reducing the requirement of blood products in cardiovascular surgeries requires not only the use of cryoprecipitates but also identifying the cases for which cryoprecipitate infusion is effective as well as changing the minds of the medical staff involved in transfusion therapy.