Acute anaphylaxis, pulmonary oedema, and intravascular haemolysis due to cryoprecipitate.

Burman, Deepa; Hodson, A.; Wood, C B; Brueton, N F

doi:10.1136/adc.48.6.483

Cited by 23 publications

(7 citation statements)

References 13 publications

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“…73 There have also been reports implicating cryoprecipitate in cases of acute anaphylactic shock, pulmonary oedema, intravascular haemolysis, and biliary complications. 42 66 74 FFP transfusion in non-massively transfused trauma patients has been shown to be associated with adverse events in a dose-dependent manner; 75 the same can be assumed to be true for cryoprecipitate. However, given that an adult dose of cryoprecipitate of ∼10 U is sourced from multiple donors, it carries a greater risk of viral transmission per dose.…”

Section: Safetymentioning

confidence: 99%

Cryoprecipitate therapy

Nascimento

Goodnough

Levy

2014

British Journal of Anaesthesia

171

135

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Cryoprecipitate, originally developed as a therapy for patients with antihaemophilic factor deficiency, or haemophilia A, has been in use for almost 50 yr. However, cryoprecipitate is no longer administered according to its original purpose, and is now most commonly used to replenish fibrinogen levels in patients with acquired coagulopathy, such as in clinical settings with haemorrhage including cardiac surgery, trauma, liver transplantation (LT), or obstetric haemorrhage. Cryoprecipitate is a pooled product that does not undergo pathogen inactivation, and its administration has been associated with a number of adverse events, particularly transmission of blood-borne pathogens and transfusion-related acute lung injury. As a result of these safety concerns, along with emerging availability of alternative fibrinogen preparations, cryoprecipitate has been withdrawn from use in a number of European countries. Compared with the plasma from which it is prepared, cryoprecipitate contains a high concentration of coagulation factor VIII, coagulation factor XIII, and fibrinogen. Cryoprecipitate is usually licensed by regulatory authorities for the treatment of hypofibrinogenaemia, and recommended for supplementation when plasma fibrinogen levels decrease below 1 g litre−1; however, this threshold is empiric and is not based on solid clinical evidence. Consequently, there is uncertainty over the appropriate dosing and optimal administration of cryoprecipitate, with some guidelines from professional societies to guide clinical practice. Randomized, controlled trials are needed to determine the clinical efficacy of cryoprecipitate, compared with the efficacy of alternative preparations. These trials will allow the development of evidence-based guidelines in order to inform physicians and guide clinical practice.

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Section: Safetymentioning

confidence: 99%

Cryoprecipitate therapy

Nascimento

Goodnough

Levy

2014

British Journal of Anaesthesia

171

135

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“…In patients receiving non-ABO compatible CRYO, a positive direct antiglobulin test and hemolysis have only rarely been reported (Burman et al, 1973). The selection of this product for transfusion usually does not require consideration of Rh compatibility.…”

Section: Pre-transfusion Compatibility Testingmentioning

confidence: 99%

Cryoprecipitate transfusion: assessing appropriateness and dosing in trauma

Nascimento¹,

Rizoli²,

Rubenfeld³

et al. 2011

Transfusion Medicine

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Cryoprecipitate is commonly used outside guidelines. In trauma, the appropriate cryoprecipitate dose and its impact on plasma fibrinogen levels are unclear.This retrospective study aims to evaluate: (1) the appropriateness of cryoprecipitate transfusion in trauma; and (2) the plasma fibrinogen response to cryoprecipitate transfusion during massive transfusion in trauma.Fibrinogen levels of < 1.0 g/L within 2 and 6 hours of cryoprecipitate transfusion were used for assessing appropriateness. Out of 394 events, 238 (60%) and 259 (66%) were considered appropriate using 2 and 6 hour criteria, respectively. A dose of 8.7 (±1.7) units caused a mean increase in fibrinogen levels of 0.55 (±0.24) g/L, or 0.06g/L per unit.In our hospital, where transfusion guidelines and policies for rapid blood product and laboratory turnaround times exist, it is possible to achieve high rates of appropriateness for cryoprecipitate transfusion in trauma. The current recommended dose causes a modest increase in fibrinogen levels.iii

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“…100 There have also been reports implicating cryoprecipitate as a cause of anaphylactic shock, intravascular hemolysis, and biliary complications. 101 The risk of infections, such as with bacteria, human immunodeficiency virus, and hepatitis viruses B and C, is similar to other transfusion units. [102][103][104][105][106][107][108][109][110][111] The risk of infections with cryoprecipitate might be higher than with fibrinogen concentrate as the latter involves more stringent steps including pasteurization, adsorption, and precipitation, which remove or inactivate a wide range of enveloped and non-enveloped viruses.…”

Section: Adverse Effectsmentioning

confidence: 99%

Use of Cryoprecipitate in Newborn Infants

Maheshwari¹,

Tyagi²,

Guaragni³

et al. 2023

Newborn

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Cryoprecipitate is a transfusion blood product derived from fresh-frozen plasma (FFP), comprised mainly of the insoluble precipitate that gravitates to the bottom of the container when plasma is thawed and refrozen. It is highly enriched in coagulation factors I (fibrinogen), VIII, and XIII; von Willebrand factor (vWF); and fibronectin. In this article, we have reviewed currently available information on the preparation, properties, and clinical importance of cryoprecipitate in treating critically ill neonates. We have searched extensively in the databases PubMed, Embase, and Scopus after short-listing keywords to describe the current relevance of cryoprecipitate.

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Acute anaphylaxis, pulmonary oedema, and intravascular haemolysis due to cryoprecipitate.

Cited by 23 publications

References 13 publications

Cryoprecipitate therapy

Cryoprecipitate therapy

Cryoprecipitate transfusion: assessing appropriateness and dosing in trauma

Use of Cryoprecipitate in Newborn Infants

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