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Fibrinogen Supplementation in Hemorrhagic Shock: Role of INTERCEPT® Fibrinogen Complex

Availability of fibrinogen sources (such as cryoprecipitated Antihemophilic Factor, cryo AHF) can be challenging given their long wait times and short shelf life. Timely administration of fibrinogen and other key clotting factors is essential to controlling hemorrhage associated with fibrinogen deficiency. This workshop describes the importance of fibrinogen supplementation during hemorrhagic shock resuscitation, the University of Miami’s early experience with INTERCEPT® Fibrinogen Complex (IFC) and how IFC improves blood availability.

Presented by:
Jonathan P. Meizoso, MD, MSPH, FACS
Assistant Professor of Surgery
University of Miami / Ryder Trauma Center
Miami, Florida

Dr. Meizoso is a trauma and acute care surgeon and scientist at the University of Miami / Jackson Memorial Hospital’s Ryder Trauma Center in Miami, FL. He completed his undergraduate, medical school, and public health training at the University of Miami and his general surgery residency at Jackson Memorial Hospital. He then went on to pursue fellowships in surgical critical care, trauma, and acute care surgery at the Ernest E. Moore Shock Trauma Center at Denver Health and the University of Colorado. He is board certified in both general surgery and surgical critical care by the American Board of Surgery.

Dr. Meizoso’s clinical and research interests focus on the detection and management of patients in hemorrhagic shock, including damage control resuscitation and massive transfusion protocols, as well as trauma-induced coagulopathy, and viscoelastic testing.

Watch the Replay
Runtime: 19 min

INTERCEPT® Blood System for Platelets Pathogen Reduction System

INTENDED USE

The INTERCEPT Blood System for Platelets is intended to be used for ex vivo preparation of pathogen-reduced Amicus apheresis platelet components suspended in 65% PAS-3/35% plasma, and Trima apheresis platelet components suspended in 100% plasma in order to reduce the risk of transfusion-transmitted infection (TTI), including sepsis, and as an alternative to gamma irradiation for prevention of transfusion-associated graft versus host disease (TA-GVHD).

CONTRAINDICATIONS

Contraindicated for preparation of platelet components intended for patients with a history of hypersensitivity reaction to amotosalen or other psoralens. Contraindicated for preparation of platelet components intended for neonatal patients treated with phototherapy devices that emit a peak energy wavelength less than 425 nm, or have a lower bound of the emission bandwidth less than 375 nm, due to the potential for erythema resulting from interaction between ultraviolet light and amotosalen.

WARNINGS AND PRECAUTIONS

Only INTERCEPT Processing Sets for platelets are approved for use in the INTERCEPT Blood System. Use only the INTERCEPT INT100 Illuminator for UVA illumination of amotosalen-treated platelet components. No other source of UVA light may be used. Please refer to the Operator’s Manual for the INT100 Illuminator. Discard any platelet components not exposed to the complete INT100 illumination process. Tubing components and container ports of the INTERCEPT Blood System contain polyvinyl chloride (PVC). Di(2-ethylhexyl)phthalate (DEHP) is known to be released from PVC medical devices, and increased leaching can occur with extended storage or increased surface area contact. Blood components will be in contact with PVC for a brief period of time (approx. 15 minutes) during processing. The risks associated with DEHP released into the blood components must be weighed against the benefits of therapeutic transfusion.

INTERCEPT® Blood System for Cryoprecipitation for the manufacturing of Pathogen Reduced Cryoprecipitated Fibrinogen Complex (INTERCEPT® Fibrinogen Complex, IFC)

INDICATIONS FOR USE

PATHOGEN REDUCED CRYOPRECIPITATED FIBRINOGEN COMPLEX

Treatment and control of bleeding, including massive hemorrhage, associated with fibrinogen deficiency.
Control of bleeding when recombinant and/or specific virally inactivated preparations of factor XIII or von Willebrand factor (vWF)
are not available.
Second-line therapy for von Willebrand disease (vWD).
Control of uremic bleeding after other treatment modalities have failed.

Limitations of Use: Pathogen Reduced Cryoprecipitated Fibrinogen Complex should not be used for replacement of factor VIII.

CONTRAINDICATIONS

Contraindicated for preparation of blood components intended for patients with a history of hypersensitivity reaction to amotosalen or other psoralens. Contraindicated for preparation of blood components intended for neonatal patients treated with phototherapy devices that emit a peak energy wavelength less than 425 nm, or have a lower bound of the emission bandwidth less than 375 nm, due to the potential for erythema resulting from interaction between ultraviolet light and amotosalen.

WARNINGS AND PRECAUTIONS

Only the INTERCEPT Blood System for Cryoprecipitation is approved for use to produce Pathogen Reduced Cryoprecipitated Fibrinogen Complex. For management of patients with vWD or factor XIII deficiency, Pathogen Reduced Cryoprecipitated Fibrinogen Complex should not be used if recombinant or specific virally-inactivated factor preparations are available. In emergent situations, if recombinant or specific virally-inactivated factor preparations are not available, Pathogen Reduced Cryoprecipitated Fibrinogen Complex may be administered.