Pesquera-Lepatan L M B, Hernandez F G, Lim R D, Chua M N
Section of Pediatric Hematology-Oncology and the Hemophilia Center, University of Santo Tomas Hospital, Manila, Philippines.
Haemophilia. 2004 Nov;10(6):684-8. doi: 10.1111/j.1365-2516.2004.01044.x.
Continuous infusion (CI) of factor VIII concentrates has been demonstrated to be cost-effective method in maintaining stable levels of FVIII activity in haemophilia A patients with major bleeding or undergoing major surgery. Cryoprecipitates remain the major source of FVIII in developing countries-like the Philippines because of limited availability and high cost of concentrates. To support the use of cryoprecipitate as alternative to FVIII concentrate for CI in centres with no factor concentrates, FVIII levels in 37 bags of random cryoprecipitate were measured at 0, 2, 4 and 6 h after thawing, kept at room temperature with bacteriological culture studies performed on the sixth hour. The mean FVIII content at hour 0 was 108.10 U per bag. Type ORh+ blood had lower FVIII content (+/-78.91 U per bag) compared with blood types ARh+ (+/-121.64 U per bag) and BRh+ (+/-117.04 U per bag). The units stored <6 months had higher FVIII content (+/-117.74 U per bag) compared with those stored for over 6- but <12-months (+/-66.77 U per bag). The mean rate of decline of FVIII activity at 2, 4 and 6 h was statistically significant at 10.35% (P = 0.000), 21.49% (P = 0.000) and 29.41% (P = 0.000) from baseline, respectively, using the paired t-test. Similar finding was found across different blood types and storage duration. Only one of 37 bags grew Staphylococcus aureus on day 10 of incubation.
对于患有严重出血或正在接受大手术的甲型血友病患者，持续输注（CI）凝血因子 VIII 浓缩物已被证明是维持 FVIII 活性稳定水平的一种经济有效的方法。由于浓缩物供应有限且成本高昂，在像菲律宾这样的发展中国家，冷沉淀仍然是 FVIII 的主要来源。为了支持在没有凝血因子浓缩物的中心使用冷沉淀替代 FVIII 浓缩物进行持续输注，对 37 袋随机抽取的冷沉淀在解冻后 0、2、4 和 6 小时测量 FVIII 水平，将其保存在室温下，并在第 6 小时进行细菌培养研究。第 0 小时时每袋冷沉淀的平均 FVIII 含量为 108.10 单位。与 A Rh+血型（每袋±121.64 单位）和 B Rh+血型（每袋±117.04 单位）相比，O Rh+血型的 FVIII 含量较低（每袋±78.91 单位）。储存时间<6 个月的冷沉淀单位 FVIII 含量（每袋±117.74 单位）高于储存 6 个月以上但<12 个月的冷沉淀（每袋±66.77 单位）。使用配对 t 检验，FVIII 活性在 2、4 和 6 小时相对于基线的平均下降率分别具有统计学意义，为 10.35%（P = 0.000）、21.49%（P = 0.000）和 29.41%（P = 0.000）。在不同血型和储存时间内发现了类似的结果。在培养第 10 天，37 袋冷沉淀中只有 1 袋培养出金黄色葡萄球菌。
