Application of cryoprecipitate as a hematostatic glue.
BACKGROUND
The effectiveness of cryoprecipitate, harvested from a patient's own fresh frozen plasma, for use in cardiac surgery as a hematostatic glue was studied in 32 randomized elective adult cardiac surgery patients from January 1993 to July 1994.


METHODS
Patients from the Toho Sakura Hospital were randomly allocated to two groups: Group 1 (n=11) received conventional fibrin glue presently available in our institution; while Group 2 (n=21) received autologous cryoprecipitate as a hematostatic glue. Surgical procedures broken down by group were as follows: Group 1: 4 CABG, 5 valvular surgeries and 2 other. Group 2: 11 CABG, 6 valvular surgery, 4 other. We preserved the patient's own blood and stored pure red cell and fresh frozen plasma (FFP). Cryoprecipitate was prepared from the FFP and preserved until required.


RESULTS
Cryoprecipitate had a 5-fold increase in fibrinogen activity (1190+/-311 mg/dl vs 238+/-34 mg/dl p<0.001), a 10-fold increase in factor VIII activity (362+/-219% vs 34+/-11%, p=0.001), and 4.5-fold increase in factor XIII activity (538+/-213% vs 119+/-50%, p<0.001), compared to serum. The amount of bleeding postoperatively was slightly lower in the cryoprecipitate glue group compared to the conventional glue group, but this was not significantly different.


CONCLUSIONS
We conclude that autologous samples of human cryoprecipitate prepared from a patient's own FFP had a strong hematostatic effect compared to conventional fibrin glue and was a very valuable hematostatic agent during cardiac surgery.
Shiono
N
N
Department of Thoracic and Cardiovascular Surgery, Toho University, School of Medicine, Tokyo, Japan.
Koyama
N
N
Watanabe
Y
Y
Tokuhiro
K
K
Suzuki
N
N
Fujii
T
T
Ozawa
T
T
Sakuragawa
H
H
Ohsawa
H
H
Iwashita
Y
Y
Sensui
S
S
Yamazaki
S
S
D000269:Adhesives; D000328:Adult; D001777:Blood Coagulation; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D005169:Factor VIII / Q000627:therapeutic use*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005340:Fibrinogen / Q000627:therapeutic use*; D005353:Fibronectins / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000097:blood / Q000517:prevention & control*; D012189:Retrospective Studies
D000269:Adhesives; D015718:Fibrin Tissue Adhesive; D005353:Fibronectins; C026912:cryoprecipitate coagulum; D005169:Factor VIII; D005340:Fibrinogen