Maintenance of hemostasis during exodontia in two hemophiliacs with factor VIII inhibitors

Zech, Ralph K.; Strother, S. Vance

doi:10.1016/s0278-2391(83)80031-7

Cited by 10 publications

(3 citation statements)

References 10 publications

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“…Because the half‐life of FVIII is about 12 h, repeated infusions may be necessary to control bleeding [1].…”

Section: High‐dose Hfviii Concentratementioning

confidence: 99%

“…Haemarthroses cause acute pain, swelling and limitation of movement; they may recur and, if improperly treated, may lead to joint destruction and ankylosis. Central nervous system (CNS) bleeding is relatively uncommon, but may occur without provocation; it is the most frequent cause of death in severely affected haemophiliacs [1]. Bleeding after surgery (including dental extraction) is prolonged.…”

Section: Introductionmentioning

confidence: 99%

“…Local fibrinolysis is thought to be a cause of bleeding after dental extraction [3]. Antifibrinolytic agents [tranexamic acid and epsilon‐aminocaproic acid (EACA)] are therefore frequently used in association with other agents when undertaking dental surgery in haemophiliacs; their efficacy may be due to their ability to inhibit clot lysis by salivary plasmin [1]. Because of the possibility of disseminated intravascular coagulation (DIC) or thrombotic complications when antifibrinolytic agents are used in conjunction with activated prothrombin complex concentrates (APCCs) [4], it has been suggested that the two treatments should be used consecutively rather than simultaneously [5].…”

Section: Introductionmentioning

confidence: 99%

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Control of bleeding in patients with haemophilia A with inhibitors: a systematic review

et al. 2003

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This paper reports a systematic review of the best available evidence of clinical effectiveness in the treatment of acute bleeding in haemophilia A patients with inhibitors. Because of the lack of randomized controlled trials (RCTs) on this topic, broad inclusion criteria with regard to study design were applied in order to assess the best available evidence for each intervention. Because of the clinical and methodological heterogeneity of the evidence, it was not appropriate to pool data across studies; instead, data were synthesized using tabulation and qualitative narrative assessment. No evidence was found to support the use of high-dose factor VIII (FVIII) in bleeding episodes. However in surgery it was found to be highly successful (100%) for low-titre, low-responding inhibitors although not reliable for high-responding inhibitors. Porcine FVIII (pFVIII) was effective in the control of severe bleeding episodes with high-titre or high-responding inhibitors (100%) and in 60-90% of surgical procedures. Activated prothrombin complex concentrates (APCCs) appear to be more effective than prothrombin complex concentrates (PCCs) in the control of mild to severe bleeding episodes. There was no good evidence for the use of PCCs in surgery. APCCs controlled bleeding in approximately 90% of surgical episodes. Recombinant factor VIIa (rFVIIa) controlled 70-100% of mild to severe bleeding episodes with high-responding inhibitors, and achieved better results when used early. It was effective in 60-100% of surgical episodes. Doses varied from study to study, and side-effects from mild to infrequent but serious adverse events were reported. The quality of the evidence is variable. Limited evidence relating to other treatment options is also included in the review.

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“…Because the half‐life of FVIII is about 12 h, repeated infusions may be necessary to control bleeding [1].…”

Section: High‐dose Hfviii Concentratementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%