Document Detail


When do we transfuse cryoprecipitate?
MedLine Citation:
PMID:  23425520     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIM: The 2001 NHMRC/ASBT Clinical Practice Guidelines for cryoprecipitate are being updated and cryoprecipitate have been incorporated into new Patient Blood Management modules. This clinical audit sought to clarify current cryoprecipitate use in Victoria, Tasmania and the Australian Capital Territory, assess adherence to guidelines and gain insights into deviations from recommended practice. This information can be utilised in updating guidelines to make them more relevant, to identify areas for clinician education and form a baseline of practice prior to release of the 2011 guidelines. METHODS: Participating institutions were invited to audit up to 30 consecutive episodes of cryoprecipitate transfusion, over an 11-month period in 2008. The audits were conducted using a standardised pro forma and involved review of patient records. These were collated electronically using algorithms to determine alignment vs. non-alignment with guidelines. RESULTS: Cryoprecipitate is used in a variety of situations with surgery accounting for the highest volume. Twenty-six per cent (26%) of transfusions were aligned with 2001 guidelines, rising to 61% with a modified fibrinogen trigger. Fibrinogen levels did not appear to dictate all clinical decisions regarding cryoprecipitate use perhaps owing to the acuity of many cases. Additional bleeding risk together with low fibrinogen levels (e.g. thrombocytopenic patients), may contribute to empiric cryoprecipitate use. CONCLUSION: These results highlight discrepancies between guidelines and practice, providing rationale for the update of the guidelines that is currently underway. Cryoprecipitate has attendant risks and it is appropriate that transfusion be restricted to situations with good evidence or sound principles to underpin use.
Authors:
M A Anderson; B Glazebrook; B Cutts; L Stevenson; L Bielby; M Borosak
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-21
Journal Detail:
Title:  Internal medicine journal     Volume:  -     ISSN:  1445-5994     ISO Abbreviation:  Intern Med J     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101092952     Medline TA:  Intern Med J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 Department of Health Victoria. Internal Medicine Journal © 2013 Royal Australasian College of Physicians.
Affiliation:
Transfusion Medicine, Australian Red Cross Blood Service.
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