title: Cryoprecipitate for transfusion: which patients receive it and why? A study of patterns of use across three regions in England.
abstract: BACKGROUND
  Despite increasing interest in the use of fibrinogen concentrates, cryoprecipitate remains the major source of fibrinogen in England.
  
  
  OBJECTIVE
  Understand patterns and indications for use of cryoprecipitate in hospitals from three English regions.
  
  
  METHODS
  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) .
  
  
  CONCLUSIONS
  Wide variation in practice and dose suggests inconsistent practice and uncertainty in the evidence informing optimal use of cryoprecipitate.
authors.affiliation: NHSBT Newcastle, Newcastle, UK. hazel.tinegate@nhsbt.nhs.uk
authors.forename: H
authors.initials: H
authors.lastname: Tinegate
authors.forename: S
authors.initials: S
authors.lastname: Allard
authors.forename: J
authors.initials: J
authors.lastname: Grant-Casey
authors.forename: S
authors.initials: S
authors.lastname: Hennem
authors.forename: M
authors.initials: M
authors.lastname: Kilner
authors.forename: M
authors.initials: M
authors.lastname: Rowley
authors.forename: F
authors.initials: F
authors.lastname: Seeney
authors.forename: S
authors.initials: S
authors.lastname: Stanworth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D004739:England; D005169:Factor VIII / Q000032:analysis / Q000627:therapeutic use*; D005260:Female; D005340:Fibrinogen / Q000032:analysis* / Q000378:metabolism / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D014947:Wounds and Injuries / Q000188:drug therapy*
chemical_list: C026912:cryoprecipitate coagulum; D005169:Factor VIII; D005340:Fibrinogen