[Perioperative use of recombinant activated factor VII (rF VIIa) in a patient with hemophilia A having inhibitors].
We experienced the perioperative management of a patient with hemophilia A having inhibitors using recombinant activated factor VII (rF VIIa). A 55-year-old man was scheduled for right total hip arthroplasty. Since he developed high titer of VIII inhibitor, rF VIIa was utilized for the hemostatic control for "bypass therapy". Dosage and interval for perioperative rF VIIa administration were determined before the surgery with a trial injection. Just before anesthesia induction, rF VIIa (9.6 mg) was given and repeated every 2 hrs during surgery till the 2nd post operative day (POD). Thereafter, rF VIIa was repeatedly given in decremental steps till 5th POD. Although intraoperative bleeding was 2500 g and 1200 ml of RBC was transfused, post surgical bleeding was minimal and no adverse effect was observed. He was discharged on 46th POD without any trouble. Perioperative rF VIIa administration is safe and useful for hemostatic control in a patient with hemophilia A having inhibitor.
Kawasaki
Yuko
Y
Anesthesiology and CCM, Hiroshima University Faculty of Medicine, Hiroshima 734-8551.
Saeki
Noboru
N
Kawamoto
Masashi
M
Yuge
Osafumi
O
Fujii
Teruhisa
T
D019644:Arthroplasty, Replacement, Hip; D019774:Blood Coagulation Factor Inhibitors / Q000097:blood*; D005169:Factor VIII / Q000037:antagonists & inhibitors*; D015942:Factor VIIa / Q000008:administration & dosage*; D006467:Hemophilia A / Q000097:blood*; D006488:Hemostasis, Surgical; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D011994:Recombinant Proteins / Q000008:administration & dosage*
D019774:Blood Coagulation Factor Inhibitors; D011994:Recombinant Proteins; D005169:Factor VIII; D015942:Factor VIIa