New guidance for cryoprecipitate dosing

An update to the 'Patient blood management guideline for adults with critical bleeding 2023 (Good Practice Statement 5)', provides guidance that a standard adult dose of fibrinogen is 3 g to 4 g.

This is achievable in Australia with:

• Fibrinogen concentrate*
• Nine units of whole blood derived cryoprecipitate and/or split apheresis cryoprecipitate (both pack types are equivalent and interchangeable), or
• Three units of apheresis cryoprecipitate (large dose packs) where laboratories still have residual stock.^

For the purpose of ROTEM/TEG guided critical bleeding protocols:

• Three units of whole blood derived and/or split apheresis cryoprecipitate should be considered an equivalent dose of fibrinogen as a 1 g vial of fibrinogen concentrate.

Hospitals participating in the FEISTY II study should continue to use the trial cryoprecipitate dosing protocol.

Access the updated guideline via the MAGICapp or the NBA website.

It's advised that health services review their local cryoprecipitate dosing guidelines, including their ROTEM/TEG guided critical bleeding/major haemorrhage protocols to be consistent with this dosing guidance. It's also recommended to share this communication with all relevant stakeholders.

^{*Fibrinogen concentrate is approved in Australia for the treatment of acute bleeding episodes in patients with congenital fibrinogen deficiency. Use of fibrinogen concentrate outside these indications (including critical bleeding) is considered ‘off-label'.}

^{^ Large volume apheresis cryoprecipitate is not currently supplied by Lifeblood. (For laboratories managing residual stock of large volume apheresis derived cryoprecipitate manufactured prior to December 2024, or dosing with mixed inventory, one large volume apheresis derived cryoprecipitate unit is equivalent to three units of whole blood and/or split apheresis cryoprecipitate)}

Do you know the next step?

Earlier this month, Lifeblood introduced an additional step in our labelling process that covers the base label volume. This ensures that the maximum pack volume (on the pack manufacturer’s label) is covered over and not confused with the red cell volume contained within the pack.

To calculate the prescribed administration rate, clinicians must always read the blood pack volume information from the Lifeblood component label, located between the component type and storage instructions.

Red cell packs in laboratory inventories prior to this change, may still have the maximum pack volume visible.

New AABB international clinical practice guidelines on red cell transfusion in acute myocardial infarction

Current guidelines advocate for a restrictive red blood cell (RBC) transfusion strategy over a liberal one in most hospitalised patient groups.

However, uncertainty regarding optimal RBC transfusion strategies for patients with acute myocardial infarction (AMI) remains as highlighted in the 2023 Guidelines from the Association for the Advancement of Blood & Biotherapies (AABB).

With the recent publication of two large randomised controlled trials (RCTs), the AABB commissioned this AMI specific guideline to reassess the current evidence base for this patient group.

New national guidance on red blood cell inventory

The National Blood Authority (NBA) released National Guidance for the Management of Red Blood Cell Inventory. This resource supports health providers in applying the National Statement for the Emergency Use of Group O Red Blood Cells, while encouraging improved inventory practices across all blood groups and reducing over-reliance on group O RhD negative red cells. Within Australia, the distribution of red blood cell groups has changed; inventory holdings need to be reassessed to reflect this change and meet patient demand.

MC module 6 live: Transfusion adverse events

The latest module in Lifeblood’s Transfusion practitioner microcredential series on adverse events is now available. This is the sixth module leading to the Lifeblood Transfusion Practitioner Certificate.

Designed specifically for transfusion practitioners, the module focuses on promoting safe transfusion practices and managing adverse events. It highlights the TP’s role in haemovigilance, procedure oversight, compliance monitoring, and education.

The module takes approximately three hours to complete and includes a range of interactive learning activities. A preview video below showcases some of the learning checks included.

Meet the Lifeblood experts

Now only a month away, it's time to look forward to BLOOD ISBT 2025 in Perth. If you're attending the conference, the Lifeblood Clinical Education Team (CET) will be hosting a stand in the exhibition hall. There you’ll find our expert team who'll help you find the right transfusion education or resource for your role or organisation.

And this year, we're offering something different. If you'd like to connect with a particular expert and learn more about Lifeblood, you can book a one-on-one chat at our stand. To arrange a session, use the QR code below or the following link to log into, or create an account with our Transfusion Online Learning portal, and select a meeting time from the online booking system. Head over to our stand (stand numbers 92, 93 and 94) in the exhibition hall of the conference and we look forward to welcoming you for your session.

Meetings will be 10 minutes in length and you're welcome to bring colleagues along, but we recommend no more than three people for any one timeslot to make sure you get the most out of your time.

Upcoming events and webinars