BLOOD PRODUCT FACT SHEET CRYOPRECIPITATE

Other Names Cryo Consent Required Yes Pre-Transfusion  Not Required  Blood Group  Group & Screen  Crossmatch Sample Not required if the patient blood group is on file in Transfusion Medicine. Approval Hematopathologist approval required in the following circumstances: Requirements • All patients except: • OR (CH or WH) • PICU, NICU • Oncology • ECLS • Transport Team requests Product CPD Cryoprecipitate Description Prepared from slowly thawed frozen plasma that is centrifuged to separate the Insoluble cryoprecipitate from the plasma. The insoluble cryoprecipitate is refrozen. Provides a source of fibrinogen, Factor VIII, Factor XIII, and von Willebrand factor. Fibronectin is also present. Each 5 – 15 mL bags bag contains a minimum of 80 IU factor VIII and at least 150 mg fibrinogen. Clinical Indications • Replacement of fibrinogen in acquired hypofibrinogenemia • Replacement of Factor XIII if obtaining specific FXIII concentrate (Fibrogammin) from Canadian Blood Services Special Access Program will cause undue delay. Contraindications • Not recommended for treatment of Hemophilia A ,von Willebrand disease. • Should not be used when specific factor concentrates are available. Risks Allergic reactions, transfusion associated circulatory overload (TACO), transfusion related acute lung injury (TRALI), bacterial contamination and transmission of infection. Dosage Recommended dose 1 unit per 5 to 10 kg body weight 1 unit = 10 to 20 mL; up to 10 units depending on indication This dosage should increase fibrinogen by 0.5 to 1 g/L If the patient is actively bleeding these guidelines may need to be exceeded. Administration Refer to blood administration procedures for details. Administer pre medications as ordered. Volumetric Method: blood infusion set with 170-200 micron filter. Syringe Method: cryoprecipitate issued in a syringe is pre- filtered and does not require an in-line filter at the time of administration. Compatible 0.9% Normal Saline only Solution Warming permitted No. Infusion Rates See table 1 below: Monitoring See table 2 below: Table 1:Infusion Rate for Cryoprecipitate in non-emergency situations Neonatal / Pediatric Adult Infusion Rate Maximum Rate Infusion Rate Maximum Rate 5 to10mLs/kg/h, or 5 to10mLs/kg/h, or within 30 min within 10 min between 30 to 60 min between 10 to 30 min

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BLOOD PRODUCT FACT SHEET CRYOPRECIPITATE

These rates may be exceeded in emergency situations Table 2: Patient Monitoring During Blood Product Transfusion Remain with the patient for the first 15 minutes following the start of each unit (when blood actually reaches the patient), and observe patient for signs and symptoms of a transfusion reaction. Neonatal (less than 4 months old) Pediatric / Adult Measure Vital signs: Measure Vital signs: 15 minutes after the start of the transfusion 15 minutes after the start of the transfusion 30 minutes after the start of the transfusion 60 minutes after the start of the transfusion 60 minutes after the start of the transfusion Hourly for remainder of the transfusion Hourly for remainder of the transfusion Within 60 minutes of completion of the transfusion Within 60 minutes of completion of the transfusion Vital signs include: Vital signs include:

Heart rate Blood Pressure Temperature Heart rate Blood Pressure

Respiration Rate O2 Saturation level Temperature Respiration rate Increase observation for high risk patient’s e.g. unaccompanied infants / children, clinically unstable or unconscious patients. Monitor O2 saturation level & fluid balance in patients who are at risk of fluid overload. In the event of a suspected transfusion reaction, STOP the transfusion and refer to the Procedure TR.07.01, Quick Reference Guide TR.07.02 and complete the Transfusion Reaction Report Form. Storage Conditions Stored in a monitored blood product storage freezer at -18C or colder. Once thawed, it is stored at 20 – 24 C. Product expires 4 hours after thawing. Return cryoprecipitate and Transfusion Record to Transfusion Medicine within 20 minutes from time of issue if there are any delays in administration. Do NOT refrigerate on nursing unit.

References Circular of Information for the Use of Human Blood Components (2011). Ottawa ON. Canadian Blood Services. Canadian Blood Services (2011). Clinical Guide to Transfusion. Retrieved August 12, 2013

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