A standardized treatment regimen for patients with severe haemophilia A undergoing orthopaedic or trauma surgery: a single centre experience

Hart, Christina and Heindl, Bernhard and Spannagl, Michael and Lison, Susanne (2015) A standardized treatment regimen for patients with severe haemophilia A undergoing orthopaedic or trauma surgery: a single centre experience. BLOOD COAGULATION & FIBRINOLYSIS, 26 (4). pp. 396-402. ISSN 0957-5235, 1473-5733

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Abstract

Recommendations on the administration of clotting factor concentrates in patients with severe haemophilia undergoing surgery are usually determined by monitoring target clotting factor levels. In this retrospective cohort study, we enrolled patients with severe haemophilia A who underwent major orthopaedic or trauma surgery. We wanted to evaluate the feasibility and the safety of a standardized medical treatment procedure. Further on, we wanted to assess whether our standardized treatment regimen enables surgical procedures in certain situations in which measuring clotting factor VIII (FVIII) activity is not available. We created a standardized medical treatment procedure that included a medical protocol and close cooperation with the Haemophilic Treatment Centre. Thirteen surgical procedures in nine patients were examined. The feasibility and safety of this standardized treatment concept were assessed by identifying perioperative complications and by means of a questionnaire. Depending on the surgery, the amount of FVIII administered within the first 10 days ranged between 653 and 1027 units/kg body weight. No allogeneic blood transfusion was required. The measurement of FVIII activity was performed repeatedly in five patients. In all patients activated partial thromboplastin time monitoring was performed during the hospital stays. The surgeons and patients were satisfied with our treatment concept and adhered to the medical regimen protocol. By means of a detailed, standardized medical protocol and by ensuring close cooperation between the patient, the surgeons and the Haemophilic Treatment Centre, we could show that elective and emergency operations can be safely performed even in situations in which FVIII activity could not be monitored. Copyright (C) 2015 Wolters Kluwer Health, Inc. All rights reserved.

Item Type: Article
Uncontrolled Keywords: TOTAL KNEE ARTHROPLASTY; FACTOR-VIII; REPLACEMENT THERAPY; JOINT DISEASE; BLOOD-LOSS; ARTHROPATHY; PROPHYLAXIS; HEMOSTASIS; SYNOVITIS; PRODUCTS; factor VIII; haemophilia; monitoring; orthopaedic surgery; standardized treatment regimen; trauma surgery
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie)
Depositing User: Dr. Gernot Deinzer
Date Deposited: 18 Jul 2019 07:10
Last Modified: 18 Jul 2019 07:10
URI: https://pred.uni-regensburg.de/id/eprint/5473

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