RiaSTAP is a fibrinogen concentrate made from pooled human plasma (may not be an option in Jehovah’s Witness patients). It was FDA approved for acute bleeding in patients with congenital fibrinogen deficiency (ie, afibrinogenemia or hypofibrinogenemia), but as an anesthesiologist, I’ve used it in the context of low fibrinogen levels amidst massive resuscitation in trauma and cardiothoracic surgery.

I reconstitute RiaSTAP in ~50 cc of sterile water and give it as an infusion over ten minutes with ongoing blood product resuscitation. Because of its low volume and ease of administration, RiaSTAP is an appealing option in patients who may not mobilize large volumes of fresh frozen plasma like those with right ventricular failure coming off of cardiopulmonary bypass.

As with all agents that promote coagulation, risks include clot formation in the lungs, deep veins, coronary arteries, etc. We must balance the risks and benefits when deciding whether to administer RiaSTAP.

Drop me a comment with questions below! 🙂

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  1. Would this be something you’d use on someone who has a history of PE’s, and has a filter? Love your posts????

    1. If a patient is hemorrhaging with refractory coagulopathy, the more pressing acute issue becomes fixing the bleeding knowing the potential risks of thromboembolic events (PEs, etc.) after initial resuscitation/stabilization.

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