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.
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