Which of the following statement(s) is/are true concerning the management of a patient with hemophilia A undergoing an elective surgical operation?
- Concentrates of factor VIII should be given several days prior to elective surgery
- The half-life of factor VIII concentrates is less than 24 hours
- A dose of 40–50 IU/kg of factor VIII concentrate should be given prior to the planned surgical procedure
- Factor VIII concentration administration should be given for the first 24 hours after surgery but may then be stopped if no abnormal bleeding has been observed
- A new recombinant preparation of factor VIII offers the advantage of being virus-free
Medicine
b. The half-life of factor VIII concentrates is less than 24 hours
c. A dose of 40–50 IU/kg of factor VIII concentrate should be given prior to the planned surgical procedure
e. A new recombinant preparation of factor VIII offers the advantage of being virus-free
Although the half-life of factor VIII is 2.9 days in normal individuals, the half-life of factor VIII concentrates is 9 to l8 hours. Levels of 80% to 100% of normal should be obtained for surgical bleeding or life-threatening hemorrhage. A dose of 40 to 50 IU/kg of factor VIII should be given with half of this dose then administered every twelve hours. After surgery, transfusion of factor VIII concentrates should be continued for at least ten days. Unfortunately, past use of concentrates of factor VIII obtained from donors has led to a high incidence of HIV infection in the hemophilia population. A new recombinant preparation of factor VIII offers the advantage of being virus-free.
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