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Presentation
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- Factor VIII & VWF (Biostate)
- (1000 IU + 10 mL water for injection)
- Prothrombin Complex Concentrate (Beriplex NZ - replaces Prothrombinex-VF)
- (500 IU + 20 mL water for injection)
- Antithrombin III (Kybernin P)
- Factor VIII inhibitor bypassing fraction (FEIBA)
- This is ordered for specific patients. Please contact Blood Bank to arrange.
- Fibrinogen concentrate (RiaSTAP)
- 1g fibrinogen in 50 mL
- This is ordered for specific patients. Please contact Blood Bank to arrange.
- Factor XIII (Fibrogammin)
- 250 IU in 4 mL water for injection, or 1250 IU in 20 mL water for injection
- Note that Fibrogammin is a Section 29 medicine
- Recombinant Factors VIIa, VIII and IX are pharmaceutical products and are not blood donor derived. Please see here for more information about them.
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Biostate
Kybernin P
FEIBA
RiaSTAP
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ABO Compatibility
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- Compatibility is not relevant for manufactured (fractionated)
plasma product transfusion
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Storage and Infusion
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- Reconstitute as soon as the bottles have reached room temperature. If any delay once reconstituted, store at room temperature or return to Blood Bank.
- Multiple vials of the same product may be pooled together.
- Give the dose IV slowly. See below for the maximum rate.
- For multiple vials a syringe infusion pump recommended. Ensure the syringe pump can deliver at the maximum rate for the product (see below)
- An inline blood filter is not indicated.
- See the Mix2Vial page for reconstition instructions
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Precautions
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- Read manufacturer's instructions carefully
- Always observe for turbidity, floating material and sediment
- Syringe infusion pumps may be used and are recommended for large doses
- Specific information about the administration of each product
is given in the manufacturer's product information
- Do not store reconstituted coagulation factors in a fridge
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Rate
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- Coagulation factors are administered
- Maximum rates for infusion/injection of each product are:
- Beriplex NZ: 3 IU/kg/min with an absolute maximum of 8mL/min (480 mL/hour)
- Biostate: 6 mL/min (360 mL/hour)
- FEIBA: 2 U/kg/min (120 mL/hour)
- Fibrogammin: 4 mL/min (240 mL/hour)
- Kybernin P: 4 mL/min (240 mL/hour)
- RiaSTAP: 5 mL/min (300 mL/hour)
- Coagulation factors should be administered directly after reconstitution and must be completed within 4 hours (3 hours for FEIBA).
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Dose
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- Factor VIII and VWF (Biostate), Antithrombin III (Kybernin P), Prothrombin Complex Concentrate (Beriplex NZ) (in Haemophilia B)
- Refer to a Haematologist
- Note: Biostate contains both FVIII and VWF in a 1:2 ratio, and is approved for use in both haemophilia A and von Willebrand disease. Each order for Biostate® should specify the "active entity" of the ordered dose. For example:
- "Biostate - 2000 IU of VWF"
- "Biostate - 100 IU of FVIII"
- Any order for Biostate that does not specify the "active entity" of the ordered dose should be clarified before the order is requested from Blood Bank or administered to the patient.
- See also Haemophilia NZ National Treatment Guidelines (2022)
- see Beriplex NZ for reversal of warfarin
- Fibrinogen (RiaSTAP): the dose per kg bodyweight is:
- where the fibrinogen level is known, the dose is the desired increment divided by 1.7
- where the fibrinogen level is unknown, the dose is 70mg/kg
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Monitoring |
- Recipients should remain under observation for 20 minutes following administration in case they experience an immediate adverse event requiring treatment.
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DO NOT
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- DO NOT add medications to blood products.
- DO NOT store reconstituted product in fridges.
- DO NOT add reconstituted factors to other infusion fluids (including saline and blood). Saline may be used to flush a line but factors are not stable suspended in other fluids.
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More Info
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