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Safety and efficacy of continuous infusion of a combined factor VIII-von Willebrand factor (vWF) concentrate (Haemate-P) in patients with von Willebrand disease.

Abstract
We studied the safety and efficacy of treatment with continuous infusion of a von Willebrand factor (vWF) concentrate Haemate-P in patients with von Willebrand disease (vWD). Three patients with mild and 5 patients with severe forms of vWD, were treated with continuous infusion of Haemate-P by minipump. The indications for treatment were: to prevent bleeding during 9 surgical procedures or 1 vaginal delivery in 6 patients and to treat 2 bleeding episodes in 2 patients. The patients were monitored daily for factor VIII (FVIII:C) and ristocetin cofactor (vWF: RCo) levels and the infusion rate was adjusted to maintain the desired therapeutic level of vWF:RCo. The treatment was effective in preventing surgical bleeding and controlling bleeding episodes. All factor VIII:C and most of the vWF:RCo levels measured during the study period were above the target therapeutic levels. A significant decrease in clearance of FVIII:C and vWF:RCo was observed over the treatment period. Haemate-P consumption averaged 24.3+/-7.9 vWF:RCo U/kg/day which is approximately half the expected dose had intermittent bolus injections been used. We suggest that continuous Haemate-P infusion is superior to intermittent bolus injections for the treatment of vWD patients by virtue of its efficiency, simplicity and considerable savings.
AuthorsA Lubetsky, S Schulman, D Varon, U Martinowitz, G Kenet, S Gitel, A Inbal
JournalThrombosis and haemostasis (Thromb Haemost) Vol. 81 Issue 2 Pg. 229-33 (Feb 1999) ISSN: 0340-6245 [Print] Germany
PMID10063997 (Publication Type: Journal Article)
Chemical References
  • von Willebrand Factor
  • Factor VIII
Topics
  • Adolescent
  • Adult
  • Blood Loss, Surgical (prevention & control)
  • Cesarean Section
  • Child
  • Elective Surgical Procedures
  • Factor VIII (administration & dosage, analysis, therapeutic use)
  • Female
  • Humans
  • Infusion Pumps
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Pregnancy
  • Pregnancy Complications, Hematologic (drug therapy)
  • Preoperative Care
  • Safety
  • Treatment Outcome
  • von Willebrand Diseases (drug therapy)
  • von Willebrand Factor (administration & dosage, analysis, therapeutic use)

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