ORIGINAL ARTICLES  CARDIAC PAPERS 

The Journal of Cardiovascular Surgery 1998 October;39(5):609-12

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Application of cryoprecipitate as a hematostatic glue

Shiono N., Koyama N., Watanabe Y., Tokuhiro K.*, Suzuki N.*, Fujii T., Ozawa T., Sakuragawa H., Ohsawa H.*, Iwashita Y.**, Sensui S.**, Yamazaki S.

From the Department of Thoracic and Cardiovascular Surgery, Toho University, School of Medicine, Tokyo, Japan * The Cardiovascular Center, ** The Division of Transfusion Toho University Sakura Hospital, Chiba, Japan

Background. The effec­tive­ness of cryop­re­cip­i­tate, har­vest­ed ­from a ­patient’s own ­fresh fro­zen plas­ma, for use in car­diac sur­gery as a hemat­os­tat­ic ­glue was stud­ied in 32 ran­dom­ized elec­tive ­adult car­diac sur­gery ­patients ­from January 1993 to July 1994.
Materials and meth­ods. Patients ­from the Toho Sakura Hospital ­were ran­dom­ly allo­cat­ed to two ­groups: Group 1 (n=11) ­received con­ven­tion­al ­fibrin ­glue pres­ent­ly avail­able in our insti­tu­tion; ­while ­Group 2 (n=21) ­received autol­o­gous cryop­re­cip­i­tate as a hemat­os­tat­ic ­glue. Surgical pro­ce­dures brok­en ­down by ­group ­were as fol­lows: Group 1: 4 ­CABG, 5 val­vu­lar sur­ger­ies and 2 oth­er. Group 2: 11 ­CABG, 6 val­vu­lar sur­gery, 4 oth­er. We pre­served the ­patient’s own ­blood and ­stored ­pure red ­cell and ­fresh fro­zen plas­ma (FFP). Cryoprecipitate was pre­pared ­from the FFP and pre­served ­until ­required.
Results. Cryoprecipitate had a 5-­fold ­increase in fibrino­gen activ­ity (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-­fold ­increase in fac­tor ­XIII activ­ity (538±213% vs 119±50%, p<0.001), com­pared to ser­um. The ­amount of bleed­ing post­op­er­a­tive­ly was slight­ly 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 ­from a ­patient’s own FFP had a ­strong hemat­os­tat­ic ­effect com­pared to con­ven­tion­al ­fibrin ­glue and was a ­very val­u­able hemat­os­tat­ic ­agent dur­ing car­diac sur­gery.