Asian Journal of Transfusion Science
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ORIGINAL ARTICLE
Year : 2016  |  Volume : 10  |  Issue : 2  |  Page : 145-149

A retrospective review of cryoprecipitate transfusion practice in Kuala Lumpur Hospital


1 Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains , 13200 Bertam, Kepala Batas, Penang; National Blood Centre, n Ministry of Health, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia
2 Department of Community Medicine, Universiti Sains , 16150 Kota Bahru, Kelantan, Malaysia
3 Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains , 13200 Bertam, Kepala Batas, Penang, Malaysia
4 National Blood Centre, n Ministry of Health, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia

Correspondence Address:
Jun Jie Tan
Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Bertam, Kepala Batas, Penang
Malaysia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6247.187934

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Background: Cryoprecipitate is generally used to treat bleeding patients with hypofibrinogenemia, and the transfusion decision is guided based on published guidelines. Aim: This study aimed to evaluate the practice appropriateness in accordance to cryoprecipitate transfusion guidelines in Hospital Kuala Lumpur. Methodology: This cross-sectional study of 117 cryoprecipitates transfused adult patients was conducted in Kuala Lumpur Hospital from January to June 2012. The compliance of the indication of cryoprecipitate was considered as appropriate if indicated for patients who have hypofibrinogenemia (<1.0 g/L) with bleeding, or otherwise inappropriate if pretransfusion fibrinogen level was more than 1.0 g/L, pretransfusion fibrinogen level was not examined and posttransfusion fibrinogen level more than 1.5 g/L. Results: Most of the cryoprecipitate prescriptions were found to be inappropriate, which read 81.2% (95% confidence interval = 0.740, 0.880). Patients who underwent neurovascular surgery were the major recipient of cryoprecipitate, but majority of the prescription was found not appropriate. The decision to transfuse cryoprecipitate was found mostly appropriate when was guided by fibrinogen (52.2%), but the percentage dropped to 10.6% when pretransfusion fibrinogen test was not performed. Regrettably, only 19.7% of total cryoprecipitate were given based on pretransfusion fibrinogen level. Conclusion: Although this study showed a high rate of inappropriateness, no reduced therapeutic efficacy, and adverse effect were reported. The trigger threshold needs to be revised before enforcing stringent implementation of practice guidelines for ensuring optimal use of cryoprecipitate.


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2006 - Asian Journal of Transfusion Science | Published by Wolters Kluwer - Medknow
Online since 10th November, 2006