Central venous access device insertion and perioperative management of patients with severe haemophilia A: a local experience.
Central venous access device (CVAD) insertion is one of the most common procedures performed on paediatric haemophilia patients. There are no clear guidelines outlining the optimal dosing schedule of factor VIII (FVIII) and duration of treatment required to achieve adequate haemostasis during and after surgery. In this article, we describe the experience at McMaster Children's Hospital using FVIII replacement therapy in 15 children with severe haemophilia A during the course of 7 years. This is a retrospective institutional chart review. Patients between 0 and 18 years of age with severe haemophilia A that underwent CVAD insertion at McMaster Children's Hospital in Hamilton, Ontario, from 2004 to 2010, were identified and charts were reviewed. A total of 15 CVAD insertion surgeries were reviewed. The total average preoperative dose of FVIII was 93.5 IU/kg (range: 53.7-145.4 IU/kg). The total average postoperative dose was 818.7 IU/kg (range: 441-1258 IU/kg). The total perioperative dose was 912.2 IU/kg (range: 495.2-1349 IU/kg). The current study attempts to describe the experience at McMaster Children's Hospital for CVAD insertion surgeries, the average factor dose administered has decreased during the years. These results may be of help in the development of optimal treatment schedules.
aDepartment of Pediatrics, McMaster University bHamilton Health Sciences cDivision of Pediatric Surgery, McMaster Children's Hospital, Hamilton, Ontario, Canada.
Adriana
A
Fonseca
Kim
K
Nagel
Kay
K
Decker
Mimitha
M
Pukulakatt
Mohan
M
Pai
Mark
M
Walton
Anthony K C
AK
Chan
D002405:Catheterization, Central Venous; D002648:Child; D002675:Child, Preschool; D003029:Coagulants / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D054796:Drug Dosage Calculations; D005169:Factor VIII / Q000627:therapeutic use*; D006467:Hemophilia A / Q000097:blood / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007223:Infant; D009864:Ontario; D012189:Retrospective Studies; D012720:Severity of Illness Index
D003029:Coagulants; D005169:Factor VIII