Early and Empirical High-Dose Cryoprecipitate for Hemorrhage After Traumatic Injury: The CRYOSTAT-2 Randomized Clinical Trial

Methodology: 3.5/5
Usefulness: 4/5

Davenport R, et al. JAMA. 2023 Oct 12:e2321019.

Editorial: Contemporary Adjuncts to Hemorrhage Control.

Question and Methods: In trauma patients with major hemorrhage, does early cryoprecipitate (6g fibrinogen) administration improve survival, compared to standard care?
Findings: There was no difference in all-cause mortality at 28 days (25.35 vs. 26.1%); OR 0.96 [95% CI 0.75-1.23] p=0.74
Limitations: Cross over between groups (15% of cryoprecipitate group didn’t receive any, 9% of control group received cryoprecipitate within 90mins) though per protocol analysis this didn’t impact the results.

Interpretation: Addition of early and empiric cryoprecipitate to standard care among adult trauma patients with major hemorrhage protocol activation, did not improve all cause 28-day mortality.

By: Dr. Mejbel Alazemi

JC Supervisor: Dr. Venkatesh Thiruganasambandamoorthy

Authors

Mejbel Alazemi

Dr. Mejbel Alazemi is a junior editor for the EMOttawa Blog, and is a FRCPC resident in the Department of Emergency Medicine, at the University of Ottawa.

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Hans Rosenberg

Dr. Rosenberg is an emergency physician at the Ottawa Hospital, associate professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.

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Venkatesh Thiruganasambandamoorthy

Dr. Venkatesh Thiruganasambandamoorthy is an attending physician and associate scientist at the Ottawa Hospital and Ottawa Hospital Research Institute with an particular interest in syncope and presyncope care.

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