Desmopressin is not always effective in mild haemophilia A patients undergoing urological surgery: the need of standardized protocols.
Desmopressin may be an efficient haemostatic treatment for mild A haemophiliacs because its infusion raises plasma factor VIII level. We report the use of desmopressin in five mild haemophilia A patients undergoing urological surgery. They all received a preoperative infusion (0.3 microg kg(-1), i.v.) 1 h before incision followed by repeated injections at 12- or 24-h intervals according to the severity of the procedure. Nevertheless, four patients presented a postoperative bleeding requiring again surgery performed for 3 of them under clotting factor concentrate instead of desmopressin. The occurrence of haemorrhage was not always correlated with particularly low plasma factor VIII level. Surgical management of urological procedures with desmopressin in mild haemophilia A patients requires standardized protocols.
Department of Haematology, Centre Hospitalier Régional et Universitaire, Lille, France.
P
P
Renom
B
B
Wibaut
J M
JM
Rigot
B
B
Coupez
J
J
Goudemand
D002648:Child; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005169:Factor VIII / Q000032:analysis / Q000627:therapeutic use; D006467:Hemophilia A / Q000097:blood / Q000188:drug therapy*; D006488:Hemostasis, Surgical / Q000379:methods*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000188:drug therapy; D011292:Premedication; D017211:Treatment Failure; D013521:Urologic Surgical Procedures, Male
D006490:Hemostatics; D005169:Factor VIII; D003894:Deamino Arginine Vasopressin