Cryoprecipitate for transfusion: Which patients receive it and why? A study of patterns of use across three regions in england
Tinegate H., Allard S., Grant-Casey J., Hennem S., Kilner M., Rowley M., Seeney F., Stanworth S.
Background: Despite increasing interest in the use of fibrinogen concentrates, cryoprecipitate remains the major source of fibrinogen in England. Objectives: Understand patterns and indications for use of cryoprecipitate in hospitals from three English regions. Method/Materials: Data collection over 3 months from adults, children and neonates receiving cryoprecipitate, including clinical scenario, indications, dose and levels of fibrinogen concentrations pre- and post-transfusion. Results: Four hundred and twenty-three episodes of cryoprecipitate transfusion were analysed from 39 hospitals. Use varied from 0·1 to 4·9 units per 100 red cells transfused. The primary indication was haemorrhage [311 episodes (74%)]. The commonest clinical scenario in all age groups was cardiac surgery, followed by trauma in adults and critical/neonatal care for children. Pre-treatment fibrinogen levels were measured in 322 episodes. In 179 episodes, the level was ≥1·0 g L-1. Conclusion: Wide variation in practice and dose suggests inconsistent practice and uncertainty in the evidence informing optimal use of cryoprecipitate. © 2012 British Blood Transfusion Society.