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Optimal care of inhibitor patients during surgery
Author(s) -
Vermylen Jos,
Peerlinck Kathelijne
Publication year - 1998
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.1998.tb01105.x
Subject(s) - medicine , haemophilia , surgery , continuous infusion , antifibrinolytic , recombinant factor viia , thrombophlebitis , intensive care medicine , tranexamic acid , anesthesia , thrombosis , blood loss
The care of haemophilia patients with high titre inhibitors during surgery has always been a formidable challenge. The introduction of recombinant activated factor VII (rFVIIa; NovoSeven®, Novo Nordisk, Bagsværd, Denmark) appears to be a major breakthrough for the management of such patients. Administration of rFVIIa as a continuous infusion is a very attractive option and precludes the need for very frequent (2‐h) injections due to the very short half‐life of the product. Successful major surgery has been performed in patients with high titre inhibitors using continuous infusion of rFVIIa. Several questions remain, however, such as optimal therapeutic level, optimal monitoring, optimal prevention of thrombophlebitis at the injection site and the necessity for antifibrinolytic agents.