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CME-Cryoprecipitate.ppt22mar

Cryoprecipitate is a concentrate of fibrinogen and other clotting factors that precipitates out when frozen plasma thaws. It is used to treat hypofibrinogenemia, bleeding related to massive transfusions, hemophilia when factor concentrates are unavailable, and von Willebrand disease unresponsive to medication. Cryoprecipitate is produced by freezing plasma, thawing it slowly, and collecting the precipitate, which contains fibrinogen and factors VIII, XIII, and von Willebrand factor.

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Contents ● What is cryoprecipitate ● Production of cryoprecipitate ● Functions of cryoprecipitate ● Indications for cryoprecipitate
• A concentrate of cold and insoluble high-molecular-weight plasma proteins. • Precipitates when frozen plasma is slowly thawed at 1–6°C. • Contains the following blood clotting proteins: o Fibrinogen o Factor VIII o Factor XIII o Von Willebrand factor What is cryoprecipitate
Production of cryoprecipitate Centrifuge whole blood Extract Plasma Snap Freeze Dry ice/alcohol -60°C for 10 minutes Attach satellite bag
Production of cryoprecipitate Thaw until there is some precipitation 3°C for 20-30 minutes Precipitated component Cryodepleted Plasma Cryoprecipitate Store at -20°C or lower
Functions of cryoprecipitate ● Fibrinogen o Fibrinogen is converted to fibrin, to form a stable blood clot at the site of vascular disruption. ● Factor VIII o Antihemophilic factor o Protein deficient or absent in individuals with classic hemophilia, an X-chromosome-linked bleeding disorder. o Participates in the intrinsic pathway of blood coagulation.
Functions of cryoprecipitate
Indications for Cryoprecipitate ● Hypofibrinogenemia* ○ fibrinogen ≤100 mg/dL [1.00 g/L] ● TPA-related life-threatening hemorrhage* ● Massive transfusion* ○ >10 RBC units in 24 h with continued bleeding ● Uremic bleeding* Accepted Indications for the Use of Cryoprecipitate at Beth Israel Deaconess Medical Center, Boston, MA*
Indications for Cryoprecipitate ● von Willebrand disease o Unresponsive to desmopressin (DDAVP) ● Hemophilia A o F VIII:C concentrates are not available ● Factor XIII deficiency o Rare hereditary deficiency o When plasma-derived F XIII concentrate (Fibrogammin P) is not available in emergent situations.
References Andersson, L. O., Forsman, N., Huang, K., Larsen, K., Lundin, A., Pavlu, B., . . . Sandberg, H. (1986, May). Isolation and characterization of human factor VIII: Molecular forms in commercial factor VIII concentrate, cryoprecipitate, and plasma. Proceedings of the National Academy of Sciences of the United States of America, 83, 2979-2983. Retrieved from http://www.pnas.org/content/83/9/2979.full.pdf Australian Red Cross Blood Service. (2014, August 22). What's in a bag of cryoprecipitate? Retrieved March 17, 2015, from http://mytransfusion.com.au/node/whats-bag-cryoprecipitate Australian Red Cross Blood Service. (2014, September 23). Use of cryoprecipitate. Retrieved March 19, 2015, from http://www.transfusion.com.au/blood_products/components/cryoprecipitate/use Australian Red Cross Blood Service. (2015, August 22). What's in a bag of cryodepleted plasma? Retrieved March 21, 2015, from http://www.mytransfusion.com.au/node/whats-bag- cryodepleted-plasma Bayer Pharma AG. (2015, March 14). The Coagulation Cascade. Retrieved from http://www.thrombosisadviser.com/en/understanding-thrombosis/the-coagulation-cascade/ Blood Component Therapy. (2010). Retrieved March 15, 2015, from http://perinatology.com/Reference/OBPharmacopoeia-Public/Blood%20component.htm
References Droubatchevskaia, N., & Wong, M. P. (2007, October 8). Guidelines for cryoprecipitate transfusion. BC Medical Journal, 49, 441-445. Retrieved March 17, 2015, from http://www.bcmj.org/article/guidelines-cryoprecipitate-transfusion Encyclopaedia Britannica. (2015). Fibrinogen. Biochemistry. Retrieved March 18, 2015, from http://global.britannica.com/EBchecked/topic/205888/fibrinogen Federici, A. B. (2003, June). The factor VIII/von Willebrand factor complex: basic and clinical issues. Haematologica, 88(6). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12826528 Lloyd, S. (2004, June). The Preparation of Single Donor Cryoprecipitate. Retrieved from http://www1.wfh.org/publication/files/pdf-1221.pdf Queen's University. (n.d.). Cryoprecipitate [Photograph]. Retrieved from https://meds.queensu.ca/central/assets/modules/clerk_bloodtrans_draft/cryoprecipitate.html Pantanowitz, L., Kruskall, M. S., & Uhl, L. (2003). Cryoprecipitate. Patterns of Use. American Journal of Clinical Pathology, 119, 874-881. Retrieved February 11, 2015, from http://ajcp.ascpjournals.org/content/119/6/874.full.pdf
References h Sparrow, R. L., Greening, D. W., & Simpson, R. J. (2011, February 23). A Protocol for the Preparation of Cryoprecipitate and Cryodepleted Plasma. Methods in Molecular Biology, 728, 259-265. Retrieved March 3, 2015, from http://link.springer.com/protocol/10.1007/978-1- 61779-068-3_17#page-1 Szymanski, I. (n.d.). Clinical Use of Plasma for Transfusion. Retrieved March 16, 2015, from http://www.fda.gov/ohrms/dockets/ac/05/slides/2005-4096S1_13.pdf Transfusion Medicine For Registrars - WPBTS.Retrieved March 5, 2015, from http://www.haematology.uct.ac.za/sites/default/files/image_tool/images/141/transfusion_medi cine_for_registrars