Adequacy of clotting factor in haemophilic patients underwent surgery based on analytical parameters and plasmatic clearance

• Autores: B. Benítez García, Elena Capilla Santamaría, José Antonio Romero Garrido, Luis González del Valle, Alicia Herrero Ambrosio
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 16, Nº. 2, 2014, págs. 110-116
• Idioma: inglés
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• Resumen

  • Objective: Assess the adequacy of the dosage of clotting factors for achieving plasma factor activity required in each patient based on analytical and pharmacokinetic parameters in patients with haemophilia undergoing major surgery. Method: Haemophilic patients without inhibitor who underwent major surgery between October 2009 and March 2010 were studied. Theoretical necessary dose of coagulation factor to maintain good coverage was calculated in every perioperative period depending on the type of haemophilia, the basal activity of the factor, the body weight, the plasmatic clearance of clotting factor, the clinical situation and the number of days after surgery of each patient. Results: Five patients with haemophilia A and one patient with haemophilia B were included. Patients with haemophilia A achieved a plasma factor activity more than 100%, before surgery and in the postoperative period (mean 154.7 ±35.02; 136.74 ±15.13% respectively). Factor units administered were higher than the theoretically required according to the basal activity of the factor and actual clearance in each patient, in presurgery period and postoperative period (8,125 and 98,330 IU respectively). Discussion: These data show that to maintain adequate haemostasis during surgery in these patients it would be advisable to consider the factor basal activity and its plasma clearance individually for each patient