Mannucci listed the dosage of Factor VIII-von Willebrand factor (vWF) concentrates need for a patient with von Willebrand's disease. The author is from the University of Milan.
Bleeding Situation
Typical Dose
Infusions Required
spontaneous hemorrhage
20 to 30 IU/kg
1 only
dental extraction
20 to 30 IU/kg
1 only
minor surgery
30 to 50 IU/kg
once a day every 1-2 days
major surgery
40 to 60 IU/kg
once a day
Bleeding Situation
Target Factor VIII Coagulant Activity
Duration of Level
spontaneous hemorrhage
> 0.3 IU/mL
dental extraction
> 0.3 IU/mL
at least 12 hours
minor surgery
> 0.3 IU/mL
until healing complete
major surgery
> 0.5 IU/mL
until healing complete
Since dosing after surgery is given until healing is complete, the least invasive method is preferred.
Knowing the half-life of the Factor VIII coagulant activity and von Willebrand Factor is important when planning a daily infusion, since the trough below the next dose has to exceed the minimum level for the period.
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