Comparison of continuous and intermittent factor VIII concentrate therapy in hemophilia A

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Abstract
Comparison of continuous versus intermittent (every 12 h bolus) infusion of a highpurity Factor VIII concentrate in 12 severe hemophilia A patients undergoing surgical procedures indicated that a higher (50 u/dl versus 35 u/dl) minimal plasma level was seen with the same amount of product when given continuously. A continuous VIII concentrate infusion of 2 u/kg/h produces a mean VIIIc level of about 50 u/dl or, alternatively, about 0.04 u/kg/h raises the VIIIc level by 1 u/dl (1%). None of the patients showed any abnormal bleeding. Higher plasma levels of VIIIc were noted by the two‐stage VIIc assay than by the one‐stage VIIIc assay. Fibrinogen levels were normal or only slightly elevated, and the monomer test was consistently negative.