Perioperative hemostasis management in patients with von Willebrand disease: an institutional experience.
Blood Coagul Fibrinolysis
; 35(2): 49-55, 2024 Mar 01.
Article
em En
| MEDLINE
| ID: mdl-38179696
ABSTRACT
OBJECTIVES:
Patients with von Willebrand disease (vWD) undergoing surgery are routinely treated with von Willebrand factor (vWF)/factor VIII (FVIII) concentrate to control bleeding risk, but consensus is lacking on optimal dosing. This study aimed to evaluate the efficacy and safety of tailored doses of vWF/FVIII concentrate according to intervention-associated bleeding risk in vWD patients undergoing surgery.METHODS:
This was a retrospective analysis of vWD patients who underwent surgical procedures at a haemophilia centre. Patients received vWF/FVIII concentrate with dosage and duration of treatment dependent on intervention type (dental, gynaecological, abdominal or orthopaedic/traumatic) and bleeding risk (moderate/high).RESULTS:
Eighty-three surgical procedures (42 patients) were included. Median preoperative loading doses of vWF/FVIII concentrate were 29.9âIU/kg and 35.7âIU/kg for interventions with moderate ( n â=â16) or high ( n â=â67) bleeding risk, respectively. The median perioperative dose was highest in orthopaedic or trauma-related surgery (140âIU/kg) and lowest in dental or gynaecological interventions (76.4âIU/kg and 80.0âIU/kg, respectively). During follow-up, no bleeding or other complications were observed in 95% of patients.CONCLUSIONS:
Individually tailored doses of vWF/FVIII concentrate according to intervention-associated bleeding risk were effective in preventing postoperative bleeding, with few complications observed. These doses may be used as guidance in routine clinical care.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças de von Willebrand
/
Hemostáticos
Tipo de estudo:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Blood Coagul Fibrinolysis
Assunto da revista:
ANGIOLOGIA
/
HEMATOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article