EFFICACY AND SAFETY OF CONTINUOUS-INFUSION OF MONONINE(R) DURING 5 SURGICAL-PROCEDURES IN 3 HEMOPHILIC PATIENTS

We report here five surgeries successfully performed with a continuous infusion of Mononine(R) (Armour Pharmaceutical Company, Kankakee, IL) in three hemophilic B patients. Before surgery the patients received a bolus dose of 40 to 100 U/kg according to the type of surgery. This injection was followed by a continuous infusion of Mononine, with an i nfusion rate of 3.5-7 U/kg/hr in order to maintain a factor IX level b etween 50 and 100% during the whole surgery and the following 6 days. The infusion rate was further adjusted according to the type of surger y until hospital discharge. This method appears to be safe and efficie nt, since no abnormal bleeding occurred during surgery and none of the patients presented any thrombotic complication. However, this alterna tive to intermittent administration of factor IX should be standardize d and precisely evaluated, regarding the level and the amount of facto r IX required, and the cost of the infused material. In our hands, thi s cost was decreased by 30-40% compared to previous therapeutic schedu les at our institution. (C) 1998 Wiley-Liss, Inc.