Implementation of pathogen reduced cryoprecipitate for surgical services: A retrospective review of blood product utilization and fibrinogen repletion
Bibliographic record
Abstract
BACKGROUND: Hypofibrinogenemia is associated with morbidity and mortality in trauma and surgery. Timely fibrinogen replacement is challenging due to storage regulations of cryoprecipitated antihemophilic factor (Cryo AHF), and the product remains susceptible to high rates of waste. FDA-approved pathogen-reduced cryoprecipitated fibrinogen complex (prCFC) has improved turnaround times and reduced waste, but there is limited information about impacts on blood product utilization and laboratory or clinical response. STUDY DESIGN AND METHODS: We performed a retrospective cohort study assessing adult surgical patients who received cryoprecipitated blood products 18 months pre- and post-implementation of prCFC. We measured differences in the utilization of blood components, change in fibrinogen post-transfusion, and the time from order to cryoprecipitated blood product administration. RESULTS: Utilization of intraoperative cryoprecipitated blood products decreased after the implementation of prCFC, but there was no difference in total perioperative cryoprecipitated blood product, RBC, plasma, or platelet transfusion. The time from order to administration was significantly reduced; however plasma fibrinogen increment and rate of achieving a fibrinogen level >150 mg/dL were lower in the post-implementation group. DISCUSSION: After the implementation of prCFC, we observed a decreased plasma fibrinogen increment per product transfused. However, there was no impact on the utilization of blood products and the time to cryoprecipitated blood product transfusion decreased. The results reinforce previously published reductions in turnaround time while uniquely assessing the time from order to transfusion. While fibrinogen increments were reduced post-implementation, this difference may not be clinically significant as there were no overall changes in perioperative transfusion of blood components.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".