Clot waveform analysis for perioperative hemostatic monitoring of arthroscopic synovectomy in a pediatric patient with hemophilia A and inhibitor receiving ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-02-10

AUTHORS

Kuniyoshi Mizumachi, Yusuke Tsumura, Yuto Nakajima, Katsuyoshi Koh, Keiji Nogami

ABSTRACT

Emicizumab reduces bleeding in patients with hemophilia A and inhibitors (PwHA-I). Coagulation potential during the perioperative period in emicizumab-treated PwHA-I undergoing surgery remains to be evaluated. We describe a 14-year-old boy with HA-I receiving emicizumab prophylaxis who experienced arthroscopic synovectomy. He was treated with a bolus infusion of recombinant factor VIIa (rFVIIa; 80 μg/kg) immediately before surgery, and treatment continued at the same dose every 3 h on day 1, every 4 h on day 2, and every 6 h on day 3. Treatment with rFVIIa was discontinued on day 4. No perioperative bleeding or thrombotic events were observed. Coagulation potential throughout the perioperative period was retrospectively assessed with an easy-to-use clot waveform analysis (CWA). Measurements from CWA returned to within or near the normal range, suggesting successful hemostatic management. Coagulation potentials assessed by CWA showed a significant correspondence with those from a thrombin generation assay (TGA) that is already in use. CWA and TGA could both provide useful data for assessing coagulation potential in the perioperative hemostatic management of emicizumab-treated PwHA-I. More... »

PAGES

930-935

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12185-021-03095-w

DOI

http://dx.doi.org/10.1007/s12185-021-03095-w

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1135323327

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33566316


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