Pro-Con Debate

Fibrinogen Concentrate or Cryoprecipitate for Treatment of Acquired Hypofibrinogenemia in Cardiac Surgical Patients

Nadia B. Hensley, MD; Michael A. Mazzeffi, MD, MPH, MSc, FASA

Disclosures

Anesth Analg. 2021;133(1):19-28. 

In This Article

Cryoprecipitate Disadvantage: Longer Acquisition Time and Shelf Life

The acquisition time for cryoprecipitate (30–40 minutes) is considerably longer compared to fibrinogen concentrate because of the need to thaw cryoprecipitate. In the cases of severe hypofibrinogenemia, as occurs in massive transfusion, delayed treatment can be quite detrimental due to dilutional coagulopathy with a fixed-ratio RBC, FFP, and platelet transfusion.

The shelf life is also much longer for fibrinogen concentrate (3 years) compared to cryoprecipitate (1 year), which may be important in smaller, rural hospitals that have a less frequent need for fibrinogen therapy.[61] There is also a longer shelf life after reconstitution because fibrinogen concentrate is able to be used for 24 hours after reconstitution versus 6 hours after cryoprecipitate thaws.

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