Cryoprecipitate: the current state of knowledge.

Cryoprecipitate is a diverse product containing factor VIII, von Willebrand factor, fibrinogen, fibronectin, factor XIII, and platelet microparticles. The role of this complex product in the management of hemostasis has not been well studied (excluding patients with factor VIII deficiency). There are insufficient data to determine the clinical setting where this product might be clinically efficacious despite its widespread use in multiple different clinical scenarios. The best method of pooling before transfusion has also not been thoroughly investigated to determine the optimal infusion strategy (intralaboratory vs bedside). The most common current indication for the use of this product is hypofibrinogenemia in the setting of massive hemorrhage. There are insufficient data in the literature to determine the efficacy, safety, and dosage in this patient population. Despite 45 years of the use of this product, we still have a lot to learn regarding the optimal use of cryoprecipitate.