Cryoprecipitate Transfusion Guidelines

Last update: March 20, 2020

Standard transfusion thresholds

• Fibrinogen < 100-150 mg/dL
  • A severely low fibrinogen can prolong the PT/INR, and giving cryo in these cases can largely correct it. This is especially common in cirrhotic patients, so please remember to check fibrinogen level along with daily PT/PTT testing in appropriate patients
  • Pregnant women have higher fibrinogen levels, and cryoprecipitate transfusion may be indicated at higher levels, such as < 200 mg/dL
• TEG alpha or K-time below laboratory normal value
• Dysfibrinogenemia

Emergency critical shortage transfusion thresholds

• During critical times of blood product shortage, the cryo transfusion threshold will be lowered.
• Every cryo unit ordered may be triaged by transfusion medicine
• A smaller dose of cryo may need to be given (ie, 5 bags instead of the usual 10 bag dose).
• Cryo transfusions may be limited to only patients with life-threatening bleeding if necessary, to preserve a limited cryoprecipitate inventory.

References

• Levy JH et al. Fibrinogen as a therapeutic target for bleeding: a review of critical levels and replacement therapy. Transfusion 2014; 54:1389-1405

Disclaimer

These documents and content on this website are guidelines during the COVID-19 pandemic. Because new information is released rapidly, these documents can be updated or changed at any time. These documents are in no way to be considered as a standard of care and the content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. The information in these documents is provided with no guarantees, accuracy, or timeliness. All content in these documents and website are for informational purposes only and do not constitute the providing of medical advice.