Cryoprecipitate

Main Uses

• Fibrinogen deficiency (based on laboratory results and clinical condition)
• Dysfibrinogenaemia when there is clinical bleeding
• Invasive procedures
• Trauma or disseminated intravascular coagulation (DIC)

Precautions

Should not be used for the treatment of haemophilia, von Willebrand's disease or deficiencies of FXIII or fibronectin unless alternative therapies (factor concentrates) are not available.

Dosage

• Compatibility testing is not required however ABO compatible plasma should be used wherever possible.
• Group AB plasma can be used for all groups in an emergency.
• Rh(D) matching is unnecessary
• ABO incompatible can be used with large volumes with caution.
• Volume depends on clinical situation, patient size and laboratory tests. A common dose for Fibrinogen replacement is 1-1.5 units per 10kg patient body weight each dose.
• Discuss with your Haematologist. For patients with specific factor deficiencies, always consider specific replacement therapy e.g. Factor VIII for Haemophilia A, rather than FFP.
• Once thawed, use immediately and complete transfusion within 6 hours of thawing (4 hours if units have been pooled).

Consent and Safety

Patient Identification

Always check the identity of the patient when taking sample for blood grouping or crossmatch before commencing the transfusion

Remember:

• Only one patient should be bled / processed at a time
• Never pre-label the specimen tubes
• Check identity by ASKING the patient to state and spell his/her name AND check the wrist band
• Check that the request form and sample match the patient and wrist band
• Remember to sign the sample and request form

Consent

Consent should be obtained and documented. Check your local institutional guidelines

Always cover the following when gaining consent:

• Explain

- Reason for this therapy
- Nature of the proposed transfusion therapy - what is involved?
- Benefits expected?
- Risks - common & rare but serious?
- Alternatives - including the risk of doing nothing?

• Ask

- Is there anything else you would like to know?
- Is there anything you do not understand?

• Provide

- Interpreter for non-English speaking patients
- Written information

Click for more detailed information. 

Administration

Transfusions Set-Up

• Mix gently but thoroughly by inversion prior to use
• Administer Cryoprecipitate through a standard giving set with an administration filter (large particle filter which only removes aggregates and other large particles)
• Complete transfusion as soon as possible

Patient Monitoring

• Start transfusion as soon as possible after thawing of Cryoprecipitate
• Check patient vital signs (pulse rate, respiration rate, blood pressure and temperature) at the start of transfusion AND at least after 15 minutes, at the end of transfusion AND if there is ANY reaction. Record observations in patients notes

When to Transfuse?

• Plan ALL transfusions during business hours. Emergency transfusions should be the only transfusions given after hours
• Transfuse ONE unit at a time

How Long Should a Transfusion Take?
- Generally 2-4 hours.
- Each unit must be transfused within 4 hours of starting
- May be given faster in acute bleeding situations