APPLICATION OF CRYOPRECIPITATE AS A HEMATOSTATIC GLUE

Background. The effectiveness of cryoprecipitate, harvested from a pat ient's own fresh frozen plasma, for use in cardiac surgery as a hemato static glue was studied in 32 randomized elective adult cardiac surger y patients from January 1993 to July 1994. Materials and methods, Pati ents from the Toho Sakura Hospital were randomly allocated to two grou ps: Group 1 (n=11) received conventional fibrin glue presently availab le in our institution; while Group 2 (n=21) received autologous cryopr ecipitate as a hematostatic glue. Surgical procedures broken down by g roup were as follows: Group 1: 4 CABG, 5 valvular surgeries and 2 othe r. Group 2: 11 CABG, 6 valvular surgery, 4 other. We preserved the pat ient's own blood and stored pure red cell and fresh frozen plasma (FFP ). Cryoprecipitate was prepared from the FFP and preserved until requi red. Results. Cryoprecipitate had a 5-fold increase in fibrinogen acti vity (1190+/-311 mg/dl vs 238+/-34 mg/dl p<0.001), a 10-fold increase in factor VIII activity (362+/-219% vs 34+/-11%, p=0.001), and 4.5-fol d increase in factor XIII activity (538+/-213% us 119+/-50%, p<0.001), compared to serum. The amount of bleeding postoperatively was slightl y lower in the cryoprecipitate glue group compared to the conventional glue group, but this was not significantly different. Conclusions. We conclude that autologous samples of human cryoprecipitate prepared fr om a patient's own FFP had a strong hematostatic effect compared to co nventional fibrin glue and was a very valuable hematostatic agent duri ng cardiac surgery.