The use of continuous infusion of factor concentrates in the treatment of hemophilia. Am J Hematol 1989 Sep;32(1):8-13
Date
09/01/1989Pubmed ID
2502914DOI
10.1002/ajh.2830320103Scopus ID
2-s2.0-0024347338 (requires institutional sign-in at Scopus site) 63 CitationsAbstract
Bolus infusion of clotting factor concentrates remains the most common approach to the treatment or prevention of bleeding in patients with hemophilia. Although successful use of continuous infusion of such concentrates has been reported by several groups, this alternative treatment method has not achieved widespread popularity. We report here our experience in one hemophilia center with the use of continuous infusion of factor VIII and factor IX concentrates in 13 patients, 11 with hemophilia A, and 2 with hemophilia B. All patients were treated successfully for bleeding episodes (e.g., hemarthroses, intracranial, or gastrointestinal bleeding) or for surgical procedures (appendectomy, thoracotomy, etc.). Three patients with low titer factor VIII inhibitors were treated successfully with constant infusion therapy, requiring a mean dose of factor VIII concentrate 2.3 fold (8.20 u/kg/h) higher than that of the patients without inhibitors (3.63 u/kg/h) to maintain a circulating plasma level of factor VIII of 1 u/ml. The use of constant infusion of clotting factor concentrates is safe, efficacious, and more convenient than bolus therapy of factor concentrates and should be considered for hospitalized hemophilia patients requiring replacement therapy.
Author List
Bona RD, Weinstein RA, Weisman SJ, Bartolomeo A, Rickles FRAuthor
Steven J. Weisman MD Professor in the Anesthesiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Child
Child, Preschool
Factor IX
Factor VIII
Hemophilia A
Hemorrhage
Hemostasis
Humans
Infusions, Intravenous
Intraoperative Complications
Surgical Procedures, Operative
Thrombosis