Correction of haemostasis can be reduced to four days for CVAD implantation in severe haemophilia A patients: Data from the PedNet study group.

Koskenvuo, Minna; Mäkipernaa, Anne; Nolan, Beatrice; Kobelt, Rainer; Ranta, Susanna (2021). Correction of haemostasis can be reduced to four days for CVAD implantation in severe haemophilia A patients: Data from the PedNet study group. Haemophilia, 27(3), pp. 392-397. Wiley 10.1111/hae.14231

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INTRODUCTION

Central venous access devices (CVAD) are used to facilitate intravenous treatment with coagulation factor concentrates (CFCs) in haemophilia A (HA). Guidelines for perioperative CFC replacement therapy are based on single centre experiences, and the length of replacement therapy varies.

AIM

The aim of this study was to evaluate whether haemostasis coverage under four days is as effective and safe as a longer period of haemostatic coverage.

METHODS

We identified patients with severe HA without inhibitors or major bleeds within one month of the surgery who received their first CVAD. We compared the CFC consumption and bleeds between children with ≤4 and those who received 5-7 perioperative treatment days including the day of surgery. Bleeds were recorded up to 4 days after the end of perioperative haemostatic coverage.

RESULTS

In total, 144 children met the eligibility criteria and were included in the study cohort: 34 had received haemostatic coverage for ≤4 days, while 110 had received 5-7 days of haemostatic coverage. One bleed related to the surgery occurred in both groups.

CONCLUSION

Overall, the bleeding complications were rare. Haemostatic coverage with CFCs under ≤4 days with elective CVAD insertions was as effective as coverage for ≥5 days.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Paediatric Haematology/Oncology

UniBE Contributor:

Kobelt, Rainer Andreas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1365-2516

Publisher:

Wiley

Language:

English

Submitter:

Jochen Karl Rössler

Date Deposited:

29 Apr 2021 08:48

Last Modified:

13 Jun 2021 01:34

Publisher DOI:

10.1111/hae.14231

PubMed ID:

33745218

Uncontrolled Keywords:

CVAD children haemophilia A replacement therapy surgery

BORIS DOI:

10.48350/154663

URI:

https://boris.unibe.ch/id/eprint/154663

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