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Blood products - cryoprecipitate (Newborn Services)

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Key points

  • Cryoprecipitate is prepared by freezing and then thawing plasma at which time a cryoprecipitate occurs which contains a high concentration of factor VIII fibrinogen, fibronectin and factor XIII.
  • Cryoprecipitate (Lyophilised) is prepared from a single donation of apheresis plasma obtained from NZ volunteer donors. It is processed within 6 hours of collection. It is suspended in buffer under sterile conditions and then lyophilised and heat treated.
  • Cryoprecipitate should be ABO compatible wherever possible.

Indications

Cryoprecipitate is mainly used as a source of fibrinogen. Patients who are actively bleeding and/or are in hypovolaemic shock - see Massive Transfusion protocol. Cryoprecipitate should NOT be used routinely for non-bleeding neonates with decreased fibrinogen.

Dosage

  • 10ml/kg
  • Cryoprecipitate does not contain an antimicrobial preservative and is therefore readily susceptible to contamination.

Administration

  • Transfusion should be started as soon as it is received from blood bank and completed within 4 hours of thawing. It will have a yellow expiratory sticker on stating date and time of expiry. Do not refrigerate after thawing otherwise insoluble cryoprecipitate may reform. If the cryoprecipitate is not going to be used or transfusion cannot be started within 30 minutes it must be returned to blood bank immediately so it can be stored appropriately and re-issued for up to 4 hours.
  • Transfuse through a standard sterile blood administration set with suitable integral screen filter (170-200 micron pore size).
  • Rate of transfusion will vary according to the clinical circumstances. Infants in hypovolaemic shock with active bleeding should be transfused as rapidly as possible.

Storage

  • Frozen cryoprecipitate is stable for one year at -30
  • Once thawed, cryoprecipitate must not be stored in the refrigerator. If it has been out of controlled storage for more than 30 minutes it cannot be accepted back into blood bank stock.

For information on checking, administration, monitoring, documentation and transfusion reactions, see  Blood products - red cell transfusion

Reference

  1. www.nzbloodservice.co.nz

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Document Control

  • Date last published: 14 August 2018
  • Document type: Clinical Guideline
  • Services responsible: Neonatology
  • Owner: Newborn Services Clinical Practice Committee
  • Editor: Sarah Bellhouse
  • Review frequency: 2 years