Retrospective review of the management of elective surgery with desmopressin and clotting factor concentrates in patients with von Willebrand disease

被引:43
作者
Nitu-Whalley, IC
Griffioen, A
Harrington, C
Lee, CA
机构
[1] UCL Royal Free & Univ Coll Med Sch, Haemophilia Ctr, London NW3 2QH, England
[2] UCL Royal Free & Univ Coll Med Sch, Haemostasis Unit, London NW3 2QH, England
关键词
von Willebrand disease; surgery; desmopressin; clotting factor concentrates; protocols;
D O I
10.1002/ajh.1058
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Limited data are available regarding optimal treatment with desmopressin (DDAVP) or intermediate-purity FVIII concentrates rich in VWF (CFCs) in patients with von Willebrand disease (VWD) who undergo planned surgery. We undertook a retrospective review over 10 years (1988-1997) and identified 27 patients treated with DDAVP for 35 surgical events and 38 patients who received CFCs for 68 elective surgical events. Tranexamic acid was usually added for mucosal surgery. The FVIII:C levels and the severity of surgery were used to determine the frequency and the doses of postoperative treatment. For major surgery the median pre- and post-operative doses of CFCs were 54 and 43 IU/kg, respectively, and for minor surgery the median doses varied between 34 and 52 IU/kg preoperatively and between 23 and 37 IU/kg postoperatively. The effectiveness of haemostasis was excellent in 32 events (91%) treated with DDAVP and in 56 events (82%) treated with CFCs. It is concluded that patients with VWD do not carry an increased operative risk if appropriate therapy is given. Am. J. Hematol. 66:280-284, 2001. (C) 2001 Wiley-Liss, Inc.
引用
收藏
页码:280 / 284
页数:5
相关论文
共 16 条
[1]   BLEEDING AFTER TONSILLECTOMY IN SEVERE VON WILLEBRANDS DISEASE [J].
ALUSI, GH ;
GRANT, WE ;
LEE, CA ;
PASI, KJ ;
PATH, MRC ;
STEARNS, MP .
JOURNAL OF LARYNGOLOGY AND OTOLOGY, 1995, 109 (05) :437-439
[2]  
BERNTROP E, 1989, VOX SANG, V56, P21
[3]   The pharmacokinetics of factor VIII and factor IX: Methodology, pitfalls and applications [J].
Bjorkman, S ;
Carlsson, M .
HAEMOPHILIA, 1997, 3 (01) :1-8
[4]  
Colvin BT, 1997, HAEMOPHILIA, V3, P63, DOI 10.1046/j.1365-2516.1997.00073.x
[5]  
Dobrkovska A, 1998, HAEMOPHILIA, V4, P33
[6]  
Federici AB, 2000, HAEMOPHILIA, V6, P71
[7]  
FOSTER PA, 1995, THROMB HAEMOSTASIS, V74, P1370
[8]  
Goudemand J, 1998, HAEMOPHILIA, V4, P48
[9]   Haemostatic treatment in connection with surgery in patients with von Willebrand disease [J].
Lethagen, S .
HAEMOPHILIA, 1999, 5 :64-67
[10]   Treatment of von Willebrand disease [J].
Mannucci, PM .
HAEMOPHILIA, 1998, 4 (04) :661-664