PROTOCOL | DEFINITION |
---|---|
On-demand treatment (episodic) | Treatment given at the time of clinically evident bleeding |
Primary prophylaxis | Regular continuous Continuous is defined as the intent of treating for 52 weeks per year and receiving a minimum of an a priori defined frequency of infusions for at least 45 weeks (85%) of the year under consideration Large joints: ankles, knees, hips, elbows and shoulders |
Secondary prophylaxis | Regular continuous Continuous is defined as the intent of treating for 52 weeks per year and receiving a minimum of an a priori defined frequency of infusions for at least 45 weeks (85%) of the year under consideration Large joints: ankles, knees, hips, elbows and shoulders |
Tertiary prophylaxis | Regular continuous Continuous is defined as the intent of treating for 52 weeks per year and receiving a minimum of an a priori defined frequency of infusions for at least 45 weeks (85%) of the year under consideration |
Intermittent prophylaxis (periodic) | Treatment given to prevent bleeding for periods not exceeding 45 weeks in a year |
SEVERITY | CLOTTING FACTOR LEVEL | BLEEDING EPISODES |
---|---|---|
Severe | <1 IU/dl (<0.01 IU/ml) or <1% of normal | Spontaneous bleeding into joints or muscles, predominantly in the absence of identifiable haemostatic challenge |
Moderate | 1–5 IU/dl (0.01–0.05 IU/ml) or 1–5% of normal | Occasional spontaneous bleeding; prolonged bleeding with minor trauma or surgery |
Mild | 5–40 IU/dl (0.05–0.40 IU/ml) or 5- <40% of normal | Severe bleeding with major trauma or surgery. Spontaneous bleeding is rare |
HAEMOPHILIA A | HAEMOPHILIA B | |||||
---|---|---|---|---|---|---|
TYPE OF | DESIRED | DURATION | INTERVAL | DESIRED | DURATION | INTERVAL |
Major surgery | ||||||
Pre-op | 80-100 | 60-80 | ||||
Post-op | 60-80 | 1-3 | 8-12 | 40-60 | 1-3 | 12 |
40-60 | 4-6 | 8-12 | 30-50 | 4-6 | 12 | |
30 -50 | 7-14 | 12 | 20-40 | 7-14 | 24 | |
Minor surgery | ||||||
Pre-op | > 50 | > 50 | ||||
Post-op | 1-5 depending | 12 | 1-5 depending | 24 | ||
FVIII/FIX should be monitored peri-operatively-, immediately postoperative and at least once daily in the hospitalised period |