Classification
A blood product used to replace fibrinogen, factor VIII, Factor XIII, and von Willebrand Factor.
Indications
CCP: Fibrinogen replacement
CCP: Factor XIII replacement
CCP: Factor VII replacement
CCP: Von Willebrand factor replacement
Contraindications
- Should not be given for a replacement of an isolated factor deficiency if the appropriate individual factor is available.
- Should not be used to treat deficiencies of other factors nor used as the sole component when replacement of multiple factors is required.
Caution
- If a transfusion reaction is suspected, stop the transfusion. Then let the hospital know as well as the blood bank.
- Massive transfusions may lead to hypothermia, hypocalcemia, and arrhythmias.
- Must use a blood administration set.
- No other fluids or any medications may be given through the blood line other than normal saline.
Adult dosages
CCP: Fibrinogen replacement
- 1 unit/5kg of patient weight (will increase fibrinogen by 100 mg/dL)
CCP: Factor XIII replacement
- 1 unit/5kg of patient weight (will provide 10U/kg)
CCP: Factor VIII replacement
- Consultation with a hematologist is recommended as dosing depends on patient factor VIII levels and requires routine monitoring.
CCP: Von Willebrand factor replacement
- Consultation with a hematologist is recommended.
- Dosing of 1 unit/10 kg of patient weight (will usually control bleeding)
Pediatric Considerations And Dosing
CCP: Fibrinogen replacement
- 1 unit/5kg of patient weight (will increase fibrinogen by 100 mg/dL)
CCP: Factor XIII replacement
- 1 unit/5kg of patient weight (will provide 10U/kg)
CCP: Factor VIII replacement
- Consultation with a hematologist is recommended as dosing depends on patient factor VIII levels and requires routine monitoring.
CCP: Von Willebrand factor replacement
- Consultation with a hematologist is recommended.
- Dosing of 1 unit/10 kg of patient weight (will usually control bleeding)
Mechanism Of Action
Each unit provides factors VIII, and XIII, plus both von Willebrand, and fibrinogen. Cryoprecipitate also contains fibronectin but there is currently no indication for fibronectin replacement. Each unit is then used to support adequate homeostasis to treat or prevent hemorrhaging.
Pharmacokinetics
- Half-life
- Fibrinogen 100-150 hours
- Factor VIII 12 hours
- Von Willebrand 24 hours
- Factor XIII 150-300 hours
Adverse Effects
- Hemolytic transfusion reaction
- Febrile non-hemolytic reaction
- Allergic reaction
- Septic reaction
- TRALI
- Circulatory overload
- Transfusion associated graft versus host disease.
- Post-transfusion purpura
Warning And Precautions
- Non-septic infection risk includes transmission of HIV, HCV, HBV, HTLV, WNV, CMV, parvovirus, Lyme disease, babesiosis, malaria, Chaga’s disease, vCJD.
- Consultation with a medical director or hematologist is required prior to initiation.
- All the factors in cryoprecipitate are found in FFP. However, the concentrations are lower requiring a larger volume of FFP.