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Adjusted dose continuous infusion of factor VIII in patients with haemophilia A.

Abstract：

:Surgical interventions in patients suffering from haemophilia A require infusions of large doses of factor VIII (F VIII) concentrates. These are expensive and may pose a burden on the immune system, which is already compromised in many haemophiliacs. F VIII is usually given as bolus injections, although there are reports on fixed dose continuous infusion. We have developed a continuous infusion programme with dosage adjusted according to daily calculation of the clearance of F VIII. Twenty-four haemophiliacs received a total of 205 d of continuous infusion with F VIII (168 d in hospital, 37 d home therapy). Eighteen patients underwent surgeries (11 elective, seven emergency) and six were treated for serious haemorrhages. We observed a significant, progressive decrease of the clearance of F VIII over the first 5 d from 3.2 (2.8-3.5) to 1.7 (1.3-1.9) ml/kg/h (median and interquartile range). The decrease of the clearance together with the fact that a continuous infusion requires less drug than bolus injections to keep the same minimal concentration, contributed to much lower doses of F VIII than reported in the literature or than required by historical controls, matched for the type of operation. Other advantages of our method are improved safety with stable activities of F VIII, lack of hazardous troughs below the haemostatic range, and the convenience, which permits ambulant therapy even when high doses of F VIII are required.

journal_name

Br J Haematol

journal_title

British journal of haematology

authors

Martinowitz U,Schulman S,Gitel S,Horozowski H,Heim M,Varon D

doi

10.1111/j.1365-2141.1992.tb06951.x

subject

Has Abstract

pub_date

1992-12-01 00:00:00

pages

729-34

issue

4

eissn

0007-1048

issn

1365-2141

journal_volume

82

pub_type

杂志文章

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