Restoring hemostasis: fibrinogen concentrate versus cryoprecipitate

Abstract

Fibrinogen plays a key role in the coagulation process, and therefore maintaining adequate quantities of fibrinogen is an essential step in achieving satisfactory hemostasis in patients with acquired hypofibrinogenemia. Potential options for treating acquired hypofibrinogenemia in patients with uncontrolled bleeding include the use of cryoprecipitate or fibrinogen replacement therapy. This review provides a brief overview of the hemostatic process and the methods for assessing coagulopathy and discusses the efficacy and safety of cryoprecipitate and fibrinogen concentrate in restoring fibrinogen levels, achieving hemostasis and reducing transfusion requirements in different patient populations requiring rapid hemostasis. Other issues relevant to the clinical use of these agents in restoring hemostasis, including variations in product composition, preparation time and cost, are also examined.

Keywords::

• cost
• cryoprecipitate
• efficacy
• fibrinogen concentrate
• fresh frozen plasma
• hemostasis
• RiaSTAP
• safety
• transfusion requirements

Financial & competing interests disclosure

The manuscript was financially supported by CSL Behring (PA, USA). B Elliott and LM Aledort met the criteria for authorship as recommended by the International Committee of Medical Journal Editors, were fully responsible for all content and editorial decisions, and were involved at all stages of manuscript development. B Elliott and LM Aledort received no honorarium for their role as authors of this manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Editorial assistance in the development of this manuscript was provided by JMM Kesslick of Connexion Healthcare (PA, USA). This assistance was funded by CSL Behring.