Введение
Кровавый продукт, полученный из плазмы крови.
Cryoprecipitate, also called cryo for short, is a frozen blood product prepared from blood plasma. To create cryoprecipitate, fresh frozen plasma thawed to 1–6 °C is then centrifuged and the precipitate is collected. The precipitate is resuspended in a small amount of residual plasma (generally 10–15 mL) and is then re frozen for storage. It is often transfused to adults as two 5 unit pools instead of as a single product. One of the most important constituents is factor VIII (also called antihaemophilic factor or AHF), which is why cryoprecipitate is sometimes called cryoprecipitated antihaemophilic factor or cryoprecipitated AHF. In many clinical contexts, use of whole cryoprecipitate has been replaced with use of clotting factor concentrates made therefrom (where available), but the whole form is still routinely stocked by many, if not most, hospital blood banks. Cryo can be stored at −18 °C or colder for 12 months from the original collection date. After thawing, single units of cryo (or units pooled using a sterile method) can be stored at 20–24 °C for up to 6 hours. If units of cryo are pooled in an open system, they can only be held at 20–24 °C for up to 4 hours. Haemophilia – Used for emergency back up when factor concentrates are not available. von Willebrand disease – Not currently recommended unless last reserve. ddAVP is first line, followed by factor concentrates. Hypofibrinogenaemia (low fibrinogen levels), as can occur with massive transfusions
Afibrinogenemia
Bleeding from excessive anticoagulation – Fresh frozen plasma contains most of the coagulation factors and is an alternative choice when anticoagulation has to be reversed quickly. Massive haemorrhage – RBCs and volume expanders are preferred therapies. Disseminated intravascular coagulation
Uremic bleeding tendency
Reversing tpa (with aminocaproic acid)
Криопреципитат, также называемый крио, – это замороженный кровяной продукт, полученный из плазмы крови. Для получения криопреципитата свежезамороженную плазму оттаивают до 1–6 °C, затем центрифугируют и собирают осадок. Осадок ресуспендируют в небольшом количестве остаточной плазмы (обычно 10–15 мл) и затем замораживают для хранения. Его часто переливают взрослым в виде двух пулов по 5 единиц, а не в виде одного препарата. Одним из наиболее важных компонентов является фактор VIII (также называемый антигемофильным фактором или АГФ), поэтому криопреципитат иногда называют криопреципированным антигемофильным фактором или криопреципированным АГФ. Во многих клинических ситуациях использование цельного криопреципитата было заменено использованием концентратов факторов свертывания, полученных из него (при наличии), но цельная форма все еще регулярно хранится во многих, если не в большинстве, больничных банков крови. Крио можно хранить при температуре −18 °C или ниже в течение 12 месяцев с даты первоначального сбора. После оттаивания отдельные единицы крио (или единицы, собранные стерильным методом) можно хранить при температуре 20–24 °C до 6 часов. Если единицы крио объединены в открытой системе, их можно хранить при температуре 20–24 °C до 4 часов.
Cryoprecipitate, also called cryo for short, is a frozen blood product prepared from blood plasma. To create cryoprecipitate, fresh frozen plasma thawed to 1–6 °C is then centrifuged and the precipitate is collected. The precipitate is resuspended in a small amount of residual plasma (generally 10–15 mL) and is then re frozen for storage. It is often transfused to adults as two 5 unit pools instead of as a single product. One of the most important constituents is factor VIII (also called antihaemophilic factor or AHF), which is why cryoprecipitate is sometimes called cryoprecipitated antihaemophilic factor or cryoprecipitated AHF. In many clinical contexts, use of whole cryoprecipitate has been replaced with use of clotting factor concentrates made therefrom (where available), but the whole form is still routinely stocked by many, if not most, hospital blood banks. Cryo can be stored at −18 °C or colder for 12 months from the original collection date. After thawing, single units of cryo (or units pooled using a sterile method) can be stored at 20–24 °C for up to 6 hours. If units of cryo are pooled in an open system, they can only be held at 20–24 °C for up to 4 hours. Haemophilia – Used for emergency back up when factor concentrates are not available. von Willebrand disease – Not currently recommended unless last reserve. ddAVP is first line, followed by factor concentrates. Hypofibrinogenaemia (low fibrinogen levels), as can occur with massive transfusions
Afibrinogenemia
Bleeding from excessive anticoagulation – Fresh frozen plasma contains most of the coagulation factors and is an alternative choice when anticoagulation has to be reversed quickly. Massive haemorrhage – RBCs and volume expanders are preferred therapies. Disseminated intravascular coagulation
Uremic bleeding tendency
Reversing tpa (with aminocaproic acid)
**Показания к применению:**
Cryoprecipitate, also called cryo for short, is a frozen blood product prepared from blood plasma. To create cryoprecipitate, fresh frozen plasma thawed to 1–6 °C is then centrifuged and the precipitate is collected. The precipitate is resuspended in a small amount of residual plasma (generally 10–15 mL) and is then re frozen for storage. It is often transfused to adults as two 5 unit pools instead of as a single product. One of the most important constituents is factor VIII (also called antihaemophilic factor or AHF), which is why cryoprecipitate is sometimes called cryoprecipitated antihaemophilic factor or cryoprecipitated AHF. In many clinical contexts, use of whole cryoprecipitate has been replaced with use of clotting factor concentrates made therefrom (where available), but the whole form is still routinely stocked by many, if not most, hospital blood banks. Cryo can be stored at −18 °C or colder for 12 months from the original collection date. After thawing, single units of cryo (or units pooled using a sterile method) can be stored at 20–24 °C for up to 6 hours. If units of cryo are pooled in an open system, they can only be held at 20–24 °C for up to 4 hours. Haemophilia – Used for emergency back up when factor concentrates are not available. von Willebrand disease – Not currently recommended unless last reserve. ddAVP is first line, followed by factor concentrates. Hypofibrinogenaemia (low fibrinogen levels), as can occur with massive transfusions
Afibrinogenemia
Bleeding from excessive anticoagulation – Fresh frozen plasma contains most of the coagulation factors and is an alternative choice when anticoagulation has to be reversed quickly. Massive haemorrhage – RBCs and volume expanders are preferred therapies. Disseminated intravascular coagulation
Uremic bleeding tendency
Reversing tpa (with aminocaproic acid)
Гемофилия – используется в качестве резервного средства при недоступности концентратов факторов.
Болезнь фон Виллебранда – в настоящее время не рекомендуется, за исключением случаев крайней необходимости. ddAVP является препаратом первой линии, за которым следуют концентраты факторов.
Гипофибриногенемия (низкий уровень фибриногена), например, при массивных переливаниях.
Афибриногенемия.
Кровотечение, вызванное чрезмерной антикоагуляцией – свежезамороженная плазма содержит большинство факторов свертывания и является альтернативным вариантом, когда необходимо быстро отменить действие антикоагулянтов.
Массивное кровотечение – предпочтительными методами лечения являются эритроцитарная масса и препараты для увеличения объема циркулирующей крови.
Диссеминированное внутрисосудистое свертывание.
Кровотечения, связанные с уремией.
Отмена действия tPA (в сочетании с аминокапроевой кислотой).
Cryoprecipitate, also called cryo for short, is a frozen blood product prepared from blood plasma. To create cryoprecipitate, fresh frozen plasma thawed to 1–6 °C is then centrifuged and the precipitate is collected. The precipitate is resuspended in a small amount of residual plasma (generally 10–15 mL) and is then re frozen for storage. It is often transfused to adults as two 5 unit pools instead of as a single product. One of the most important constituents is factor VIII (also called antihaemophilic factor or AHF), which is why cryoprecipitate is sometimes called cryoprecipitated antihaemophilic factor or cryoprecipitated AHF. In many clinical contexts, use of whole cryoprecipitate has been replaced with use of clotting factor concentrates made therefrom (where available), but the whole form is still routinely stocked by many, if not most, hospital blood banks. Cryo can be stored at −18 °C or colder for 12 months from the original collection date. After thawing, single units of cryo (or units pooled using a sterile method) can be stored at 20–24 °C for up to 6 hours. If units of cryo are pooled in an open system, they can only be held at 20–24 °C for up to 4 hours. Haemophilia – Used for emergency back up when factor concentrates are not available. von Willebrand disease – Not currently recommended unless last reserve. ddAVP is first line, followed by factor concentrates. Hypofibrinogenaemia (low fibrinogen levels), as can occur with massive transfusions
Afibrinogenemia
Bleeding from excessive anticoagulation – Fresh frozen plasma contains most of the coagulation factors and is an alternative choice when anticoagulation has to be reversed quickly. Massive haemorrhage – RBCs and volume expanders are preferred therapies. Disseminated intravascular coagulation
Uremic bleeding tendency
Reversing tpa (with aminocaproic acid)
Побочные эффекты
Нежелательные реакции, о которых сообщалось при использовании криопреципитата, включают гемолитические реакции при переливании, лихорадочные негемолитические реакции, аллергические реакции (от крапивницы до анафилаксии), септические реакции, острое повреждение легких, связанное с переливанием крови, перегрузку объема циркулирующей крови, трансфузионный болезнь «трансплантат против хозяина» и посттрансфузионную пурпуру.
История
Метод получения крио был открыт Джудит Грэм Пул из Стэнфордского университета в 1964 году, а в 1971 году он был впервые одобрен Управлением по санитарному надзору за качеством пищевых продуктов и медикаментов США под названием криопреципитат ФVIII для Хоксвортского центра крови Медицинского центра Университета Цинциннати.