Articles  |   March 2018
ACE Question
Article Information
Education / CPD / Articles
Articles   |   March 2018
ACE Question
ASA Monitor 03 2018, Vol.82, 38-39.
ASA Monitor 03 2018, Vol.82, 38-39.
Cryoprecipitate would be least effective for the treatment of bleeding in a patient with which of the following disorders?
Cryoprecipitate contains fibrinogen, factor VIII, von Willebrand factor, factor XIII and fibronectin. Other coagulation factors are not present in any appreciable amount. The predominant pathological process associated with hemophilia B (Christmas disease) is a deficiency in factor IX. Because this factor is not present in cryoprecipitate, it would not be an effective treatment for the disease.
Because of the decreased risk of infectious complications, commercially available factor concentrate is the standard therapy for a patient with hemophilia. In the absence of factor VIII concentrate, cryoprecipitate can be used to treat bleeding secondary to hemophilia A (factor VIII deficiency). Bleeding in patients with von Willebrand disease is most often treated with desmopressin. However, cryoprecipitate can be a relatively effective treatment because it contains von Willebrand factor. Because there is a significant amount of fibrinogen in cryoprecipitate, it can be an effective treatment for bleeding in low fibrinogen states. Fibrinogen concentrate would also be an effective treatment for bleeding in the presence of hypofibrinogenemia; however, it is not approved for use in the United States.
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