Protocols - Hemorio

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- Extended surgeries require increased doses of Prothrombin Complex, such as 75 to 100mg/Kg or rFVIIa. - All exceptional cases must be analyzed by the Hemostasis Group and evaluated by the Head of Assistance. TABLE 4: TREATMENT OF BLEEDING EPISODES IN THE PRESENCE OF INHIBITOR Ac BLEEDING FVIII pcc APCC Low response Low titer Low response High titer High response High titer High response Low titer Mild high doses 12/12h - - Moderate high doses 12/12h - - Severe high doses 12/12h 50 to 75 U/kg/ dose 12/12h - Mild - 50 to 75 U/kg/ dose 12/12h - Moderate - 50 to 75 U/kg/ dose 12/12h - Severe - 75-100 U/kg / dose 12/12h Mild - - 75-100 U/kg/dose 12/12hs Moderate - - 75-100 U/kg/dose 12/12hs Severe - - 75-100 U/kg/dose 12/12hs Mild - 50 to 75 U/kg/dose 12/12hs - Moderate - 50 to 75 U/kg/dose 12/12hs 50 -75 U/kg/dose 12/12hs Severe - 50 to 75 U/kg/dose 12/12hs 75-100 U/kg/dose 12/12hs Note: The dose interval depends on the severity of the bleeding and the individual response. In cases of PCC and APCC it must not exceed 5 doses and the use of Antifibrinolytic should not be associated due to the risk of thrombosis. 2 - VON WILLEBRAND DISEASE (Ministry of Health – August, 2006) TYPES (Evan Sadler Classification): TYPE DEFICIENCY 1 2 3 − 60-80% of VWD cases − Reduction of all multimeters, with preserved function − Dominant autosomal trait, with variable penetrance − 10-30% of VWD cases − Reduction of functional activity of multimeters (types 2A, 2B, 2M and 2N) − Dominant autosomal or recessive trait − Subtypes: 2A, 2B, 2M e 2N − 1-5% cases − Very reduced or undetectable levels − Recessive autossomal transmission − 10-15% patients develop antibodies against FVW, after several infusions DIAGNOSIS: VWD diagnosis is based on the presence of three conditions: a) Personal history of mucous or skin bleedings; b) Family history of bleeding manifestations; c) Laboratorial tests which demonstrate a quantitative and/or qualitative FvW defect. 72
DIAGNOSIS ALGORITHM: Key: FVIII:C ↓ FVW:Ag N or ↓ FVW:RCo ↓ FVW:RCo/FVW:Ag=0.7 – 1.2 VWD Type 1 VWD subtype 2B VWD subtype 2A VWD subtype 2M VWD subtype 2N VWD type 3 FVW:Ag ↓ ↓ ↓ FVW:RCo ↓ ↓ ↓ FVIII:C=0.5-1% FVIII:C=10-40% FVW:Ag N FVW:RCo N FVW:FVIII changed FVW:CB N or ↓ Presence of MAPM RIPA ↓ – RIPA ↑ FVW: Ag N or ↓ FVW:RCo ↓ FVW:RCo /FVW:Ag=0.7 FVIII:C N or ↓ 73
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PROTOCOLS INSTITUTE OF HAEMATOLOGY
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COORDINATION AND REVISION Clarisse
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SUMMARY: PART I - CLINICAL PROTOCOL
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1.INICIAL CLINICAL EVALUATION SICKL
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TREATMENTO AND IN ADULTS AT ANY AGE
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SPLENECTOMY - INDICATIONS: (1) CHIL
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OUTPATIENT TREATMENT: It is based o
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ASPIRIN AND NSAID PARACETAMOL OPIOI
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CONDUCTION: - Hospitalization - Com
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ONE, TWO-DIMENSIONAL DOPPLER ECHOCA
Page 22 and 23: Hemianopsia Homonymous deficit of v
Page 24 and 25: TREATMENT OF CONVULSIVE EPISODES -
Page 26 and 27: INITIAL ATTENDANCE TO PREGNANT WOME
Page 28 and 29: - It may occurs acute thoracic synd
Page 30 and 31: 3 Diet with potassium restriction 4
Page 32 and 33: MICROALBUMINURIA Screening Patients
Page 34 and 35: RECURRENCE OF PRIAPISM: - Pain Trea
Page 36 and 37: SPECIAL CARES DEFERASIROX - The use
Page 38 and 39: TREATAMENT: DRUG Hydroxiurea (hard
Page 40 and 41: MAJOR AND INTERMIDIATE THALASSEMIA
Page 42 and 43: HEREDIRATY SPHEROCYTOSIS CLINICAL E
Page 44 and 45: G6PD DEFICIENCY INITIAL EVALUATION
Page 46 and 47: LABS EXAMS TO DIAGNOSE APLASTIC ANE
Page 48 and 49: SELFIMMUNE HEMOLYTIC ANEMIA CONCEPT
Page 50 and 51: 2. Splenectomy: Vaccinate 14 days b
Page 52 and 53: IMMUNE THROMBOCYTOPENIC PURPURA LAB
Page 54 and 55: THROMBOTIC THROMBOCYTOPENIC PURPURA
Page 56 and 57: HEMORRHAGIC SYNDROME INTRODUCTION H
Page 58 and 59: MULTIDISCIPLINARY FOLLOW-UP OF HEMO
Page 60 and 61: LYOPHILIZED CONCENTRATES: They are
Page 62 and 63: TABLE 2: REPLACEMENT THERAPY TO PER
Page 64 and 65: CONDUCTION IN CONFIRMED INTRACRANIA
Page 66 and 67: Severe CET with neurological change
Page 68 and 69: PHARMACOKINETICS OF CLOTTING FACTOR
Page 70 and 71: INHIBITORS CLASSIFICATION The inhib
Page 74 and 75: CLINICAL DIAGNOSIS: According to In
Page 76 and 77: DDAVP TEST The “test dose” must
Page 78 and 79: TREATMENT OF BLEEDING SITUATIONS SI
Page 80 and 81: TABLE 6 - REPLACEMENT THERAPY IN LE
Page 82 and 83: • Primary prophylaxis: controvers
Page 84 and 85: CLINICAL AND LABORATORIAL FOLLOW-UP
Page 86 and 87: MYELODISPLASIC SYNDROME LABORATORIA
Page 88 and 89: If EPO < 500 mU/ml : EPO (8000U 3x/
Page 90 and 91: ACUTE MYELOID LEUKEMIA LABORATORIAL
Page 92 and 93: LMA LMA M3 - non-M3 LMA Protocol LM
Page 94 and 95: Key: Volunteer to aggressive treatm
Page 96 and 97: Acute Promyelocytic Leukemia Transf
Page 98 and 99: BMP LMA IN CHILDREN AND TEENAGERS
Page 100 and 101: Ara-c dose reduction by age: Age in
Page 102 and 103: ATRA RECOMMENDATION: ATRA is starte
Page 104 and 105: - venous hydration - leukapheresis
Page 106 and 107: POLYCYTHEMIA VERA LABORATORIAL TEST
Page 108 and 109: TREATMENT - 2nd LINE - Indicated fo
Page 110 and 111: ACUTE LYMPHOID LEUKEMIA LABORATORIA
Page 112 and 113: RE-INDUCTION Phase I (weeks 1-4) -
Page 114 and 115: Cycles 2, 4, 6, 8 - Methotrexate 20
Page 116 and 117: PHASE 2 Infusion CPM in 1 hour 1000
Page 118 and 119: CURATIVE RADIOTHERAPY of CNS < 1 ye
Page 120 and 121: CHRONIC LYMPHOCYTIC LEUKEMIA LABORA
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fludarabine 25 mg/m VENOUS 2 D1-D3
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TRICHOLEUKEMIA LABORATORIAL TESTS -
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- age >45 years old - leukocytosis
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- Leukemia / T-Cell Lymphoma in Adu
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INDICATIONS FOR THE TREATMENT: Symp
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1 st line Chemotherapy R- CHOP (21
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CODOX- M/IVAC Cycles 1 and 3 Cyclop
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BLOCK A DEXA VO/IV 10 mg /m2 in 3 d
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- Surgical treatment is only indica
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LEUKEMIA / T-CELLS LYMPHOMA OF THE
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HN2 or PUVA (similar to the located
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MULTIPLE MYELOMA LABORATORIAL TESTS
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RESPONSE CRITERIA Full Response Abs
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WALDENSTRON MACROGLOBULINEMIA LABOR
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− If HLA-identical related donor
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TREATMENT PROTOCOL - ACUTE MYELOID
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TREATMENT PROTOCOL - MULTIPLE MYELO
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Post-autologous transplantation pro
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PART II - TRANSFUSIONAL PROTOCOLS A
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PRESERVATION AND CONSERVATION: The
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TRANSFUSION OF RED BLOOD CELLS, PLA
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FORMAL CONTRAINDICATIONS TO THE PLA
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1 - TRANSFUSION OF FROZEN FRESH PLA
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COMMUNICATION FORM OF CRYOPRECIPITA
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Volume to be = changed (*) VOLEMIA
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HEMOTHERAPIC PROTOCOL TO FALCIFORM
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5 - TRANSFUSIONAL CONDUCT AT THE SE
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CML - Subjects with symptoms relate
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- Aplastic anemia bearers - HIV pos
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Severe reaction: anaphylactic shock
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- Heart monitoring - Prescribe Furo
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CARES AT THE PLATELETS CONCENTRATE
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ATTACHMENT I - HEMATOLOGICAL CLINIC
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INFECTIOUS SPLENO MEGALIES IMMUNO L
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INVESTIGATION OF HEMORRHAGIC SYNDRO
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INVESTIGATION OF POLYGLOBULIAS: POL
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ATTACHMENT III - HEMATOLOGY SPECIAL
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IMMUNOPHENOTYPE PROFILE OF THE ACUT
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ATTACHMENT IV - PAIN APPROACH ROUTI
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If it is prescribed for more than 1
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HOW TO PRESCRIBE OPIOID: SPECIAL CA
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SPECIFICITIES OF EACH OPIATE (cont
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METHADONE Intravenous (*) Oral path
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Psychic Dependence or “addiction
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CROSS TOLERANCE - The subject must
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ATTACHMENT V - CHEMOTHERAPY SUBJECT
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ATTACHMENT VII - IRON CHELATION GEN
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10. G N N - DFP DFP-100 mg/kg/day d
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ATTACHMENT VIII - SEDATION IN CHILD
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224 NOTES _________________________
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224 NOTES _________________________
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Expresso Gráfica e Editora Ltda-me
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Protocols - Hemorio

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