Cryoprecipitate vs FFP

[alicealicealice]

Cryoprecipitate contains Factors 8,13, VWF, and Fibrinogen.
FFP has all the factors but low fibrinogen if Im not mistaken.

In warfarin OD, you give FFP.
I believe in DIC you give FFP.
In TTP you perform exchange transfusion and avoid platelets.

Have you ever come across a question where cryoprecipitate is the answer? Its not really used for VWD or hemophilia anymore AFAIK.
Besides underlying cause, what would be the best answer for transfusion in DIC?

Thanks.

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[Missorleans]

Cryoprecipitate contains Factors 8,13, VWF, and Fibrinogen.
FFP has all the factors but low fibrinogen if Im not mistaken.

In warfarin OD, you give FFP.
I believe in DIC you give FFP.
In TTP you perform exchange transfusion and avoid platelets.

Have you ever come across a question where cryoprecipitate is the answer? Its not really used for VWD or hemophilia anymore AFAIK.
Besides underlying cause, what would be the best answer for transfusion in DIC?

Thanks.

I think for step 1 purposes, cryoprecipitate is still the answer for vWD and hemophilia. That was the explanation UWorld gave on a warfarin OD question I got recently.

 

[Instatewaiter]

Cryoprecipitate contains Factors 8,13, VWF, and Fibrinogen.
FFP has all the factors but low fibrinogen if Im not mistaken.

In warfarin OD, you give FFP.
I believe in DIC you give FFP.
In TTP you perform exchange transfusion and avoid platelets.

Have you ever come across a question where cryoprecipitate is the answer? Its not really used for VWD or hemophilia anymore AFAIK.
Besides underlying cause, what would be the best answer for transfusion in DIC?

Thanks.

DIC with low fibrinogen- answer=cryo

 

[alicealicealice]

Just as curiosity cryo + FFP or just cryo?
I can imagine the argument going both ways in that adding more factor + more fibriongen to a patient in DIC is like adding fuel to a fire, but I guess you cant let them bleed to death...

 

[ChessMaster3000]

Just as curiosity cryo + FFP or just cryo?
I can imagine the argument going both ways in that adding more factor + more fibriongen to a patient in DIC is like adding fuel to a fire, but I guess you cant let them bleed to death...

At the same time, you can definitely give FFP in DIC. Finally, It could be appropriate to give both. I find it extremely hard to believe that in DIC they would make you distinguish between ffp and cryo in a straight DIC patient. Good to think about, but I really find that hard to believe. That's step 2-3 level right there. As you probably know, far more common a test scenario is someone on warfarin overdose, and what do you give them?

 

[Instatewaiter]

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[Instatewaiter]

Just as curiosity cryo + FFP or just cryo?
I can imagine the argument going both ways in that adding more factor + more fibriongen to a patient in DIC is like adding fuel to a fire, but I guess you cant let them bleed to death...

They tend not to bleed if you stay on top of the fibrinogen. We usually let them be if not bleeding and fibrinogen >150. If they are hemorrhaging, correct coagulopathy with vit K and FFP and give cryo +/- plt.

Where I cam from, we'd also often do low dose heparin to prevent getting to the bleeding stage.

 

[ChessMaster3000]

Weird, given the fact that you know, I'm a board certified internist who has actually treated DIC.

sorry, that probably came off the wrong way. its hard for me some times to parse out what one would do in the real world versus the optimal response in a standardized test situation, especially when the clinical approaches are diverse and/or conflicting. so that was just me trying to hash it all out

 

[Instatewaiter]

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