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 History and use in Cardiac Surgical Patients

Cryoprecipitate was serendipitously discovered by Judith Graham Pool in the 1960s at Stanford University.[10,11] Dr Pool noted that when plasma was thawed, very little factor VIII was present in the supernatant, whereas abundant factor VIII was present in the unthawed material at the bottom of the container. This observation led to the use of cryoprecipitate for treating the patients with hemophilia A and von Willebrand disease (VWD). Currently, cryoprecipitate is rarely used to treat hemophilia A and VWD because concentrated, lyophilized, plasma-derived, and recombinant products are available for both diseases. Instead, cryoprecipitate is used to treat acquired hypofibrinogenemia in cardiac surgery, multitrauma, obstetrical hemorrhage, and other critical care settings.[12] Until recently, cryoprecipitate was the only effective treatment for acquired hypofibrinogenemia in cardiac surgical patients.

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