Haemostasis with cryoprecipitate in patients undergoing surgery for severe von Willebrand disease.

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dc.contributor.authorMathews, Ven_US
dc.contributor.authorSrivastava, Aen_US
dc.contributor.authorNair, S Cen_US
dc.contributor.authorChandy, Men_US
dc.date.accessioned2000-07-26en_US
dc.date.accessioned2009-06-03T05:52:35Z
dc.date.available2000-07-26en_US
dc.date.available2009-06-03T05:52:35Z
dc.date.issued2000-07-26en_US
dc.description.abstractBACKGROUND: There are limited data on the management of haemostasis in patients with severe von Willebrand disease undergoing major surgery. Data on the use of cryoprecipitate in this setting are even more limited. In many developing countries cryoprecipitate is often the only available source of factor replacement. The minimum factor levels required for maintaining haemostasis after surgery have never been carefully evaluated. METHODS: Data from 3 patients with severe von Willebrand disease who underwent 4 major surgical procedures at our institution, using lower than standard recommended doses of cryoprecipitate were analysed for adequacy of factor replacement and complications. RESULTS: The average preoperative cryoprecipitate infusion was 22.5 i.u. of factor VIII/kg (range: 15-25). The bleeding time done by the modified Ivy method, 30 minutes after infusion, was normal in all these patients. The average cryoprecipitate support for days 1-3 was 16.5 i.u. of factor VIII/kg/day (range: 12.5-25) and for days 4-10 was 12.4 i.u. of factor VIII/kg/day (range: 8.3-16). The mean duration of factor replacement was 12 days (range: 7-17). Two patients had delayed bleeding, one on day 3 attributed to the inadvertent use of a non-steroidal anti-inflammatory drug and the second on day 10 which was probably secondary to septicaemia. Bleeding resolved in both these patients as soon as the precipitating factors were relieved. CONCLUSION: The total amount of factor replaced in our patients is approximately half of what would have been used if the usual recommendations were followed. The data suggests that lower doses of cryoprecipitate could be adequate for major surgery and wound healing in severe von Willebrand disease. This will lead to lowering of costs and reducing the risk of transfusion-associated virus infection.en_US
dc.description.affiliationChristian Medical College and Hospital, Vellore, Tamil Nadu, India.en_US
dc.identifier.citationMathews V, Srivastava A, Nair SC, Chandy M. Haemostasis with cryoprecipitate in patients undergoing surgery for severe von Willebrand disease. National Medical Journal of India. 2000 Jul-Aug; 13(4): 188-90en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/118666
dc.language.isoengen_US
dc.source.urihttps://www.nmji.inen_US
dc.subject.meshAdulten_US
dc.subject.meshCost Savingsen_US
dc.subject.meshFactor VIII --administration & dosageen_US
dc.subject.meshFemaleen_US
dc.subject.meshFibrinogen --administration & dosageen_US
dc.subject.meshHemostasis, Surgicalen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshPostoperative Careen_US
dc.subject.meshvon Willebrand Disease --surgeryen_US
dc.titleHaemostasis with cryoprecipitate in patients undergoing surgery for severe von Willebrand disease.en_US
dc.typeJournal Articleen_US
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