Successful use of ReFacto continuous infusion in two paediatric patients with severe haemophilia A undergoing orthopaedic surgery

Abstract

In this report we describe the successful use of B-domain-deleted recombinant factor VIII (ReFacto) administered by continuous infusion during orthopaedic procedures in two children with severe haemophilia A. Both patients underwent ankle synovectomy and in patient 2, a medial patellofemoral ligament repair was performed in the same operative session. Patient 2 developed septic arthritis A in his knee joint and arthroscopic joint irrigation and debridement was performed 2 weeks after the initial procedure. Surgical cover was initiated with a bolus dose of ReFacto 50 IU kg-1 followed by continuous infusion at 3.3-4.8 IU kg-1 h-1 which was maintained for up to 9 days postoperatively. Patient 2 received an additional bolus dose of 15 IU kg-1 during the infusion period. All procedures were performed without haemostatic complications and long-term orthopaedic outcomes were good in both patients. © 2004 Blackwell Publishing Ltd.