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cryoprecipitate
Prepared by slowly thawing fresh frozen plasma at 4-6 degrees C. The precipitate is collected & refrozen.
Components:
1) factor VIII: 80-120 units/ unit of cryoprecipitate
2) fibrinogen: 200-250 mg/unit
3) fibronectin
4) factor XIII
5) von Willebrand's factor
Indications:
1) active bleeding in von Willebrand's disease*
2) active bleeding with plasma fibrinogen < 100 mg/dL [2]
3) treatment of choice for fibrinogen deficiency due to DIC, liver disease or thrombolytic therapy [2]
4) dysfibrinogenemia
5) hemophilia A (factor VIII is better)
6) factor XIII deficiency [2]
7) also used for preparing topical fibrin glue for surgical hemostatis
* von Willibrand factor-rich factor VIII concentrate is preferable
Procedure:
Transfusions:
- generally pooled for use. 10 units is common
- ABO blood group compatible preferred
- standard 170 micron filter
- repeat transfusions every 8-10 hours [3]
Complications:
- transfusion related infection (not virally inactivated) [2]
General
transfusion component
References
- Saunders Manual of Medical Practice, Rakel (ed),
WB Saunders, Philadelphia, 1996, pg 613-614
- Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 17, 18.
American College of Physicians, Philadelphia 1998, 2012, 2015, 2018.
- Veterans Administration