Replacement therapy for invasive procedures in patients with haemophilia: literature review, European survey and recommendations

摘要: Although most surgical and invasive procedures can be performed safely in patients with haemophilia, the optimal level duration of replacement therapy required to prevent bleeding complications have not been established conclusively. For providing more insight into during procedures, a literature review haemophilia was conducted. Concomitantly, current practice surveyed 26 European Haemophilia Comprehensive Care Centres, representing 15 different countries. The identified 110 original papers published between 1965 2007. Of these, only two studies were randomized controlled trials. Target levels as follows. major orthopaedic surgery: preoperative targets 80-90%; postoperative showed high degree variation, trough ranging from 20% 80%, 10-14 days; for liver biopsy, 70-100%, 1-7 tonsillectomy: 90-100%, 5-11 indwelling venous access device insertion: 100%, 3-10 circumcision: 50-60%, 2-4 dental 30-50%, single treatment. With exception surgery, Europe, assessed by survey, largely agreement data. In conclusion, this study provides both comprehensive large survey undergoing procedures; these data informed consensus practical treatment recommendations made paper. This highlights need better-designed order better define minimal haemostatic duration.