Background/Case Studies: INTERCEPT Fibrinogen Complex (IFC) is a newly available blood product indicated for fibrinogen replacement. IFC differs from Cryoprecipitate AHF in that it can be stored post thaw at room temperature for 5 days. A focus for care improvement at our institution has been cryoprecipitate preparation and utilization during massive transfusion protocols (MTP). The goal of this project was to deploy fibrinogen replacement faster in MTP while also decreasing cryoprecipitate wastage associated with proactive thawing.
Study
Design/Methods: 6 months of cryoprecipitate data were pulled pre and post IFC implementation, March 2022 - August 2022 and September 2022 - February 2023. A retrospective review was performed to evaluate cryoprecipitate issue time comparisons and wastage. Analysis was performed using Microsoft Excel.
Results/Findings: Sixty-two IFC were issued and 18 IFC were discarded during the trial. Twenty-six IFC were issued during massive transfusion protocols (10 trauma and 16 non-trauma), 12 IFC were issued during OB Hemorrhages, 12 IFC were issued to fill STAT OR requests, and 12 IFC were issued to the general patient population because they were within 24 hours of expiration. Actual transfusion times were not analyzed due to inconsistent recording during hemorrhage protocols. Table 1 summarizes the cryoprecipitate data at our institution pre and post IFC implementation. The cryoprecipitate wastage rate at our institution was 6.4% pre IFC implementation and 4.9% post implementation, but IFC specifically had a 22.5% wastage rate, primarily due to fibrin clots found during visual inspection prior to issue. Conclusions: IFC does allow faster issue of fibrinogen product from the blood bank. IFC did not have a statistically significant impact on fibrinogen concentrate use in adult patients. An unexpectedly high wastage rate of IFC was encountered due to clots forming in the products after storage at room temperature. Further investigation of optimal handling and storage conditions are ongoing.
Importance of research: INTERCEPT Fibrinogen Complex is a newly available blood product indicated for fibrinogen replacement that can be stored at room temperature for 5 days post thaw. This trial found that IFC does allow faster issue of fibrinogen replacement, but this product had an unexpectedly high wastage rate due to fibrin clots found after storage at room temperature. Further investigation of optimal handling and storage conditions are ongoing.
