[The administration of factor VIII concentrates to hemophiliacs by continuous perfusion pump]

The administration of factor VIII (FVIII) in continuous infusion (CI) to hemophiliac inpatients is a therapeutic approach made possible by the development of new commercial preparations.

In the present study the outcome of 14 treatment courses of FVIII in CI to 12 patients with hemophilia A (2 of them with inhibitor) was evaluated. A computer program developed by the authors is presented. This program is simple and can be executed in any compatible personal computer, permitting the calculation of initial and maintenance doses and individual pharmacokinetic parameters.

The hemostatic result was excellent: constant FVIII plasma levels were achieved, and unnecessary overdoses were prevented. Mean infusion rates of 1.99 +/- 0.45 IU/kg/h, 1.47 +/- 0.28 IU/kg/h, and 0.86 +/- 0.12 IU/kg/h were enough to maintain FVIII plasma levels of 1 IU/ml, 0.3 IU/ml, and 0.3 IU/ml, respectively. This represents a saving of 20-50% of the requirements of the traditional intermittent method.

The infusion of intravenous CI of FVIII and the use of a computer program permitting an easy individualization of the treatment schedule resulted in the same hemostatic effectiveness as with the traditional intermittent method, but using a smaller replacement dose.