Twenty-Four-Hour Exchange Transfusion in the Management of Severe Volume load in a Hemophilia B Patient

Abstract

Abstract: This paper presents a case report of a 9-year-old hemophilia B with an infected pseudotumor at the right calcaneum. He recaived two subsequent operations, one below the knee amputation on Day 5 and one disarticulation of the knee on Day 26 of hospitaliation. The hemostasis was maintained with 30-50 mlkg/d of cryoremoved plasma or fresh frozen plasma, and limited amounts of prothrombin complex and factor IX concentrates. Although intravenous diuretics were simultaneously given, he develobed dysonea and pulmonary congestion which resulted in pulmonary edema and hyperoncotic acute renal failure on Day 35. Therefore, an exchange transfusion of two times the blood volume using three infusion pumps was performed for 24 hours to manage the severe volume overload with a successful outcome. The patient completely recovered and was discharged from the hospital on Day 55 of hospitalization.