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Continuous infusion factor replacement in haemophilia B during and after cardiac surgery: the better choice?.

MedStar author(s):

Citation: BMJ Case Reports. 13(11), 2020 Nov 30.PMID: 33257355Institution: MedStar Washington Hospital Center | Washington Cancer InstituteDepartment: Medicine/Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Coronary Artery Bypass | *Factor IX/ad [Administration & Dosage] | *Hemophilia B/dt [Drug Therapy] | Factor IX/me [Metabolism] | Hemophilia B/bl [Blood] | Hemophilia B/co [Complications] | Humans | Infusions, Intravenous | Male | Middle Aged | Recombinant Proteins/ad [Administration & Dosage]Year: 2020 ISSN:

1757-790X

Name of journal: BMJ case reportsAbstract: A 57-year-old man with mild haemophilia B was admitted for coronary artery bypass graft surgery. His factor IX (FIX) activity was 15% on admission. Our goal was to maintain his FIX activity at 80%-100% for post-op days (PODs) 0-3, and at 60%-80% for PODs 4-14. Preoperatively, the patient was given recombinant FIX (rFIX) bolus using the formula:Dosage needed=%(desired FIX level-current level of FIX)xweight (kg)x1.3. This increased his activity to 100%. One IU of rFIX increased FIX activity by 0.8%; the half-life of rFIX is 18-24 hours. The rFIX infusion was started intraoperatively and continued after surgery to maintain target FIX activity. He was discharged on POD 9 on rFIX bolus dosing of 5000 IU every 12 hours for an additional 5 days. Using continuous factor infusion, we managed to decrease the amount rFIX used by >60% while maintaining steady state FIX activity level. Copyright (c) BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.All authors: Farid S, Sewaralthahab S, Smith HPOriginally published: BMJ Case Reports. 13(11), 2020 Nov 30.Fiscal year: FY2021Digital Object Identifier:

https://dx.doi.org/10.1136/bcr-2020-235859

ORCID:

http://orcid.org/0000-0001-6682-9709

Date added to catalog: 2020-12-31

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Title notes ( 2 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	33257355	Available		33257355

A 57-year-old man with mild haemophilia B was admitted for coronary artery bypass graft surgery. His factor IX (FIX) activity was 15% on admission. Our goal was to maintain his FIX activity at 80%-100% for post-op days (PODs) 0-3, and at 60%-80% for PODs 4-14. Preoperatively, the patient was given recombinant FIX (rFIX) bolus using the formula:Dosage needed=%(desired FIX level-current level of FIX)xweight (kg)x1.3. This increased his activity to 100%. One IU of rFIX increased FIX activity by 0.8%; the half-life of rFIX is 18-24 hours. The rFIX infusion was started intraoperatively and continued after surgery to maintain target FIX activity. He was discharged on POD 9 on rFIX bolus dosing of 5000 IU every 12 hours for an additional 5 days. Using continuous factor infusion, we managed to decrease the amount rFIX used by >60% while maintaining steady state FIX activity level. Copyright (c) BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.

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