The safety and efficacy of adjusted continuous infusion (CI) of recombinant factor IX (FIX; BeneFix) was assessed in vitro and in a clinical study. BeneFix was reconstituted at 100 IU mL-1 with or without unfractionated heparin (4 U mL-1) and stored at either 4 degrees C or room temperature. Reconstituted BeneFix retained at least 90% activity over 14 days if stored at 4 degrees C but stability was reduced at room temperature. BeneFix reconstituted in a sterile pharmacy was free of bacterial contamination. Six patients with haemophilia B received seven CIs of BeneFix to cover routine surgery and severe bleeding episodes. The CIs lasted between 3 and 10 days. In all cases, haemostasis was excellent and the desired therapeutic FIX level was easily maintained. No thrombotic episodes or inhibitor development occurred but two patients developed thrombophlebitis at the infusion site when heparin was not added to the infusion. BeneFix is not currently licensed for CI and we suggest that studies to enable licensing should be established as soon as possible.
Further studies should be undertaken with other pre-registration nursing student cohorts to compare the results with this research. There should be: an increase in self-directed learning; a 'family-friendly' approach to the curriculum by allocating self-directed study during school holidays; a reduction in the number of theory hours to coincide with students' external commitments and to assist them with the demands of studying; and time for private study before the submission of theoretical assignments.
Further studies should be undertaken with other pre-registration nursing student cohorts to compare the results with this research. There should be: an increase in self-directed learning; a 'family-friendly' approach to the curriculum by allocating self-directed study during school holidays; a reduction in the number of theory hours to coincide with students' external commitments and to assist them with the demands of studying; and time for private study before the submission of theoretical assignments.
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