Content of One Packet of Cryoprecipitate
One single unit (packet) of cryoprecipitate contains 400-450 mg of fibrinogen, factor VIII, von Willebrand factor, factor XIII, and fibronectin in a volume of 20-40 ml. 1, 2
Composition and Characteristics
- Cryoprecipitate is a leucodepleted plasma product containing concentrated coagulation factors produced by further processing of fresh frozen plasma (FFP) 1
- Each single unit contains approximately 400-450 mg of fibrinogen 1, 2
- Besides fibrinogen, cryoprecipitate contains factor VIII (antihemophilic factor), von Willebrand factor, factor XIII, and fibronectin 3, 4
- The typical volume of one unit is 20-40 ml 1
- Pools of five units contain at least 2 g of fibrinogen and are typically provided in 100-200 ml per bag 1, 2
Storage and Administration
- Cryoprecipitate is stored at -25°C until needed 1
- Once thawed for administration, it can be kept at ambient temperature for up to 4 hours and should not be refrigerated again 1, 2
- The adult dose is typically two pools (10 units); transfusion should be performed using a standard blood giving set with a 170-200 μm filter 1, 2
- For patients born in 1996 or later, cryoprecipitate is made from FFP sourced outside the UK and undergoes viral inactivation with methylene blue 1
Clinical Comparison with Other Products
- The fibrinogen content of four units of FFP is approximately 2 g, compared with approximately 4 g fibrinogen in two pools of cryoprecipitate 1
- Cryoprecipitate has a much higher concentration of fibrinogen than FFP, making it more efficient for fibrinogen replacement 1, 5
- While fibrinogen concentrate provides a more predictable amount of fibrinogen (20 g/L when reconstituted), cryoprecipitate contains additional coagulation factors that may be beneficial in certain clinical scenarios 6
- The variability in fibrinogen content between individual units of cryoprecipitate can be significant, with studies showing considerable variation between preparations 7, 8
Primary Clinical Indications
- Hypofibrinogenemia due to major hemorrhage and massive transfusion 1, 9
- During major hemorrhage, fibrinogen should be maintained >1.5 g/L (except in active obstetric hemorrhage where >2 g/L fibrinogen should be maintained) 1, 9
- Combined liver and renal failure with bleeding 1, 9
- Bleeding associated with thrombolytic therapy 1, 9
- Disseminated intravascular coagulation with fibrinogen <1.0 g/L 1, 9
- Advanced liver disease, to maintain fibrinogen level >1.0 g/L 1, 9