Blood Product Utilization Guidelines

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Cryoprecipitate Transfusion Guidelines

Last update: March 20, 2020

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Standard transfusion thresholds

  • Fibrinogen < 100-150 mg/dL
    • A severely low fibrinogen can prolong the PT/INR, and giving cryo in these cases can largely correct it. This is especially common in cirrhotic patients, so please remember to check fibrinogen level along with daily PT/PTT testing in appropriate patients
    • Pregnant women have higher fibrinogen levels, and cryoprecipitate transfusion may be indicated at higher levels, such as < 200 mg/dL
  • TEG alpha or K-time below laboratory normal value
  • Dysfibrinogenemia

Emergency critical shortage transfusion thresholds

  • During critical times of blood product shortage, the cryo transfusion threshold will be lowered.
  • Every cryo unit ordered may be triaged by transfusion medicine
  • A smaller dose of cryo may need to be given (ie, 5 bags instead of the usual 10 bag dose).
  • Cryo transfusions may be limited to only patients with life-threatening bleeding if necessary, to preserve a limited cryoprecipitate inventory.


  • Levy JH et al. Fibrinogen as a therapeutic target for bleeding: a review of critical levels and replacement therapy. Transfusion 2014; 54:1389-1405


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