Cryoprecipitate for transfusion: which patients receive it and why? A study of patterns of use across three regions in England

SUMMARY Background Despite increasing interest in the use of fibrinogen concentrates, cryoprecipitate remains the major source of fibrinogen in England. Objectives Understand patterns and indications for use of cryoprecipitate in hospitals from three English regions. Method/Materials Data collection over 3 months from adults, children and neonates receiving cryoprecipitate, including clinical scenario, indications, dose and levels of fibrinogen concentrations pre‐ and post‐transfusion. Results Four hundred and twenty‐three episodes of cryoprecipitate transfusion were analysed from 39 hospitals. Use varied from 0·1 to 4·9 units per 100 red cells transfused. The primary indication was haemorrhage [311 episodes (74%)]. The commonest clinical scenario in all age groups was cardiac surgery, followed by trauma in adults and critical/neonatal care for children. Pre‐treatment fibrinogen levels were measured in 322 episodes. In 179 episodes, the level was ≥1·0 g L−1. Conclusion Wide variation in practice and dose suggests inconsistent practice and uncertainty in the evidence informing optimal use of cryoprecipitate.