The Amount of Fibrinogen in Cryoprecipitate by In-hospital Preparation

Abstract

Background: Cryoprecipitate contains high concentrations of fibrinogen (Fib) that is effective for dilutional coagulopathy in massive blood transfusions. The supply of cryoprecipitate by in-house preparation in our hospital began in July 2013. There is heterogeneity in the Fib content of fresh frozen plasma (FFP) and cryoprecipitates. Here, we measured the Fib content of cryoprecipitates prepared in our hospital. Methods: We measured the Fib content of 2,715 cryoprecipitate bags prepared in our hospital. Four randomly selected bags were used as the basic order unit, and the amount of Fib per four bags was measured for 579 orders. The number of bags and Fib content of cryoprecipitate administered in all 487 surgical cases were examined. Results: The average amount of Fib per bag was 516.3±166.8 mg/bag. Per four bags, 551 orders (95.2%) contained >1,500 mg and 28 orders (4.8%) contained <1,500 mg, and 6.1±2.0 bags of cryoprecipitate and 3,115.0±1.0 mg of Fib were administered per surgical case. Conclusion: The Fib content of cryoprecipitates varied widely, reflecting the heterogeneity of Fib concentrations in FFP. A large amount of cryoprecipitate must be administered to deliver sufficient Fib. Therefore, besides cryoprecipitate, the use of Fib preparations should be considered in treating severe dilutional coagulopathy.

Keywords

• massive blood transfusion
• cryoprecipitate
• fibrinogen
• dilutional coagulopathy