Cryoprecipitate for the correction of coagulopathy associated with liver disease

Anaesthesia and Intensive Care
C J FrenchP Angus

Abstract

In patients with liver disease at risk of pulmonary oedema, cryoprecipitate (small volume) might be a viable alternative to fresh frozen plasma (FFP, large volume) in the correction of coagulopathy. However, the efficacy of cryoprecipitate in these patients has not been tested. We evaluated the role of cryoprecipitate in the correction of the coagulopathy of liver disease. To establish initial evidence of efficacy, six consecutive patients with hepatic failure and coagulopathy received five units of cryoprecipitate. Then, using a crossover design, 11 consecutive patients were randomized to receive either four units of FFP or five units of cryoprecipitate. Pre and post infusion International Normalized Ratio (INR), activated Partial Thromboplastin Time (aPTT), fibrinogen D-dimers, Factors V and IX, and reptilase time were measured. In the first six patients, cryoprecipitate improved the INR, aPTT and fibrinogen concentration (P = 0.03). In the crossover study, FFP administration produced a greater improvement in INR (P = 0.007) and aPTT (P = 0.005) than cryoprecipitate. However, there were no differences in any of the other measured variables. One patient developed acute pulmonary oedema while receiving FFP. Cryoprecipitate impr...Continue Reading

References

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Citations

May 4, 2007·Nature Clinical Practice. Gastroenterology & Hepatology·A James Hanje, Tushar Patel
Sep 9, 2006·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Peter McCallDarshi Karapillai
Sep 22, 2012·Transfusion Medicine·L YangT Baglin
Apr 15, 2014·British Journal of Haematology·Saad F IdrisMartin Besser
Mar 23, 2021·Journal of Veterinary Emergency and Critical Care·Jennifer Prittie
Dec 27, 2005·Best Practice & Research. Clinical Haematology·Richard K Spence
Sep 1, 2021·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Ahmet SeyhanliFatih Demirkan

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