Protocols - Hemorio

Note: Surgical procedures must be preceded by inhibitor research or recovery curve of infused
factor.
MAJOR SURGERIES
(1) PRE-OPERATORY: - increase FVIII or FIX to 100%%, 30 to 60 minutes before surgery
(2) POST-OPERATORY:
MAJOR SURGERIES
PRE-OPERATORY D1 – D3 D4 – D7 D8 – D14
50% 50% 50%
100%
FVIII - 8/8 H
FIX – 12/12 H
12/12 h 24/24 h
WARNING:
- Surgical procedures must be preceded by inhibitor research or recovery curve of infused factor.
- Dose FVIII or FIX every 3 days (minimum level) - standardization of dose efficacy and identification of
potential inhibitor.
- Always re-evaluate replacement therapy doses according to clinic, especially due to volume hematomas
and infection.
- By guidance of Hemostasis Group, the factor’s continuous infusion may be performed.
CONTINUOUS INFUSION OF VIII FACTOR
INDICATION
- Hemorrhage of ileopsoas muscle
- Compartment syndrome
- Muscular or joint extended hemorrhage
- Surgeries
MATERIAL
- Conventional Infusion Pump - Saline
- FVIII Concentrate - Heparin
- Plastic Bag - Laminar Flow
MATERIAL PREPARATION: FVIII concentrates are diluted in the plastic bag with saline solution with total
volume 200ml. Handling must be performed in sterile conditions, with laminar flow, gloves and masks. It is
recommended the addition of 2-5 IU/ml heparin of total solution into the infusion pump to avoid
thrombophlebitis at the puncture site. The bags are changed every 12 hours.
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