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The role of cryoprecipitate in human and canine transfusion medicine
Author(s) -
Prittie Jennifer
Publication year - 2021
Publication title -
journal of veterinary emergency and critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.886
H-Index - 47
eISSN - 1476-4431
pISSN - 1479-3261
DOI - 10.1111/vec.13034
Subject(s) - cryoprecipitate , medicine , coagulopathy , fresh frozen plasma , intensive care medicine , fibrinogen , transfusion medicine , blood transfusion , von willebrand disease , surgery , von willebrand factor , platelet
Abstract Objective To evaluate the current role of cryoprecipitate in human and canine transfusion medicine. Data sources Human and veterinary scientific reviews and original studies found using PubMed and CAB Abstract search engines were reviewed. Human data synthesis In the human critical care setting, cryoprecipitate is predominantly used for fibrinogen replenishment in bleeding patients with acute traumatic coagulopathy. Other coagulopathic patient cohorts for whom cryoprecipitate is recommended include those undergoing cardiovascular or obstetric procedures or patients bleeding from advanced liver disease. Preferential selection of cryoprecipitate versus fibrinogen concentrate (when available) is currently being investigated. Also a matter of ongoing debate is whether to administer this product as part of a fixed‐dose massive hemorrhage protocol or to incorporate it into a goal‐directed transfusion algorithm applied to the individual bleeding patient. Veterinary data synthesis Although there are sporadic reports of the use of cryoprecipitate in dogs with heritable coagulopathies, there are few to no data pertaining to its use in acquired hypofibrinogenemic states. Low fibrinogen in dogs (as in people) has been documented with acute traumatic coagulopathy, advanced liver disease, and disseminated intravascular coagulation. Bleeding secondary to these hypocoagulable states may be amenable to cryoprecipitate therapy. Indications for preferential selection of cryoprecipitate (versus fresh frozen plasma) remain to be determined. Conclusions In the United States, cryoprecipitate remains the standard of care for fibrinogen replenishment in the bleeding human trauma patient. Its preferential selection for this purpose is the subject of several ongoing human clinical trials. Timely incorporation of cryoprecipitate into the transfusion protocol of the individual bleeding patient with hypofibrinogenemia may conserve blood products, mitigate adverse transfusion‐related events, and improve patient outcomes. Cryoprecipitate is readily available, effective, and safe for use in dogs. The role of this blood product in clinical canine patients with acquired coagulopathy remains unknown.