Daily Bolus of LR: Factor Replacement in Hemophilia A

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January 18, 2012 by dailybolusoflr

Factor Replacement in Hemophilia A


Hemophilia A or Factor VIII deficiency is a hematologic disorder where patients have insufficient levels of circulating Factor VIII, which can lead to either spontaneous bleeding and significant life threatening bleeding in the setting of both minor and major trauma.


Measured by elevations in PTT and Factor VIII Level Activity


Commonly accepted that patients with Factor Level Activity:

·         Under 1% are severe

·         1-5% are moderate

·         5-10% are mild


For patients with bleeding:

·         You can transfuse with cryoprecipitate (rich in factors) if Factor VIII is not available

·         You can replace Factor VIII


The amount of Factor VIII given is related to the severity of the bleeding present:

·         1 Unit of Factor VIII/kg increases the activity level by about 2%

·         12.5 Units/kg for mild bleeding

·         25 Units/kg for moderate bleeding

·         50 Units/kg for severe bleeding (the goal here is to replace to 100% and this is used in patients with head trauma- even prophylactically)


Ref: Rosen’s 7th ed




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