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Life-threatening Bleeding in Hemophilia A Patients
- Although an infrequent occurrence, patients with Hemophilia A can present with life-threatening hemorrhage (e.g. ICH).
- Recall that normal clotting factor levels range from 50-150 IU/dL - reported by the lab as 50-150%.
- Life-threatening bleeding requires Factor VIII levels between 80-100%. In general, each unit of FVIII/kg raises plasma levels by 2%.
- Recombinant Factor VIII products are preferred over plasma derived concentrates or blood products and are dosed as:
- FVIII - 50 IU/kg loading dose followed by infusion of 3 IU/kg/hr
- In the event you don't have access to recombinant or plasma derived FVIII concentrates, cryoprecipitate (contains FVIII) can be used.
References
Singleton T, Kruse-Jarres R, Leissinger C. Emergency department care for patients with Hemophilia and Von Willebrand Disease. JEM 2010; 39:158-65.