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 Processing

Cryoprecipitate is derived from fresh frozen plasma (FFP), which is frozen within 8 hours of collection. FFP can be thawed in a water bath or a refrigerator, and plasma supernatant is separated from precipitate using centrifugation.[13] Plasma supernatant is discarded except for a small volume (10–15 mL), which is kept to suspend the cryoprecipitate.[13] Multiple single donor units of cryoprecipitate (typically 5 or 6 units) are combined into a single pooled unit using sterile "welding." Pooled cryoprecipitate is refrozen and stored at a temperature <−18 °C for 1 year. When frozen cryoprecipitate is thawed for transfusion, it must be used within 6 hours and cannot be refrozen. The main reason for this is that factor VIII activity decreases quickly at room temperature. Alternatively, fibrinogen content is stable up to 5 weeks.[14]

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