Revisiting hemophilia management in acute medicine

Sahu, Sandeep; Lata, Indu; Singh, Saurabh; Kumar, Mukesh

doi:10.4103/0974-2700.82225

Cited by 15 publications

(11 citation statements)

References 23 publications

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“…Less common presentations of haemophilia reported are intracranial haemorrhage, spinal haematoma, retropharyngeal haemorrhage, tracheal haemorrhage, lingual haematoma, upper and lower gastrointestinal bleeding, ruptured abdominal organ or capsular haematoma of the abdominal viscera, ruptured appendix, ruptured pelvic or abdominal pseudotumour and intraorbital or periorbital haemorrhage 5. Very rarely, it presents as a pseudotumour of the bone 6.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous bladder rupture: unusual presentation in a haemophilic child

2017

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A 4-year-old boy child presented with abdominal pain, haematuria, lower abdominal mass and urinary retention. There was no family history of bleeding. Ultrasound abdomen revealed an intravesical blood clot, rupture of the anterior bladder wall and perivesical haematoma. Contrast-enhanced CT (CECT) confirmed the findings. The child had a history of previous gum bleeding which prompted work-up for coagulation disorder. Investigations confirmed haemophilia. Following clotting factor replacement, surgical exploration was done. Intraoperatively, a 3 cm extraperitoneal, longitudinal tear on the anterior bladder wall was found along with haematoma in the bladder and perivesical space. Evacuation of the haematoma and repair of the bladder tear was performed. Postoperative period was uneventful, and the child was asymptomatic at 6-month follow-up. To the best of our knowledge, spontaneous bladder rupture has not been reported in a haemophilic child.

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Section: Discussionmentioning

confidence: 99%

Spontaneous bladder rupture: unusual presentation in a haemophilic child

2017

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“…This assay is a model for large‐vessel injury involving the transection of both the tail's central artery and the two lateral veins mimicking a major surgery procedure due to the associated risk of a large volume blood loss. In addition, it may also be used for monitoring both continuous bleeding loss and delayed bleeding or rebleeding events, which are characteristic features of severe haemophilia . In that sense, the tail bleeding assay constitutes a well‐suited model to complement functional in vivo data acquired with the most common existing acute haemostasis models described in the literature, especially the ferric chloride‐induced carotid artery injury and cremaster injury models .…”

Section: Discussionmentioning

confidence: 99%

A quantitative and humane tail bleeding assay for efficacy evaluation of antihaemophilic factors in haemophilia A mice

et al. 2014

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The tail bleeding model using haemophilic mice has been used as one of the standard assays for efficacy evaluation of novel antihaemophilic therapies at the preclinical level. A number of different configurations and endpoints have been proposed in the literature for this model, hindering interlaboratory comparisons. A particular configuration, known as the tail bleeding survival assay (TBS), adopted by several groups, involves measuring the ability of conscious haemophilic mice to survive exsanguination following tail transection. Major limitations to this configuration include ethical constraints and impaired quantitative determinations. The aim of this study was to standardize and validate a quantitative haemostatic assay for evaluation of antihaemophilic therapies employing an alternative to TBS, which involves a more humane endpoint associated with stable clot formation. Haemophilic mice were treated with vehicle or different doses of two antihaemophilic reference products licensed in Brazil. The haemostatic response was evaluated by our quantitative tail bleeding haemostatic assay (qTBA) over a period of 120 min and then quantified by dose-response modelling. We demonstrate that our qTBA method allows a direct relationship between the number of animals which achieved full haemostatic response and the dosage of both antihaemophilic factors evaluated over 120 min. In addition, the method sensitivity is suitable to demonstrate the conversion from a severe to a moderate haemophilia phenotype. Our proposed qTBA is easy to implement and constitutes an alternative and more ethical endpoint, which could be effectively used as a surrogate to the commonly employed survival endpoint, allowing quantitative haemostatic response evaluation associated with stable clot formation.

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“…Systemic indications of hemorrhage, such as tachycardia, tachypnea, hypotension, and orthostatic hypotension, should be noted and treated as medical emergencies. 18 Postoperative bleeding may require the administration of additional factor and blood product. Surgical response to postoperative bleeding may be evacuation of the hematoma or cauterization of the wound bed.…”

Section: Postoperative Complicationsmentioning

confidence: 99%

Management of Surgical Patients With Bleeding Disorders

Kauffman¹

2014

Journal of Infusion Nursing

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Invasive procedures for patients with bleeding disorders require planning on the part of the health care team. The patient population affected involves those with hereditary bleeding disorders, such as von Willebrand disease or hemophilia; in addition, patients who use antithrombotic drugs must be considered and their care managed. The choice of treatment depends on a number of factors, including the procedure planned, the type and severity of the disorder, and the age and morbidity of the patient. The indications, dosing, and timing of presurgical and surgical interventions will be reviewed, as well as special considerations for vascular access devices.

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Revisiting hemophilia management in acute medicine

Cited by 15 publications

References 23 publications

Spontaneous bladder rupture: unusual presentation in a haemophilic child

Spontaneous bladder rupture: unusual presentation in a haemophilic child

A quantitative and humane tail bleeding assay for efficacy evaluation of antihaemophilic factors in haemophilia A mice

Management of Surgical Patients With Bleeding Disorders

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