{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:42:47Z","timestamp":1785804167335,"version":"3.56.0"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,5,28]],"date-time":"2013-05-28T00:00:00Z","timestamp":1369699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>von Willebrand's disease (VWD) patients undergoing major surgery are prophylactically treated to promote haemostasis. There is variability in perioperative clinical practice; however, most guidelines suggest replacing the deficient factor to a level of 1.0\u00a0IU\u00a0mL<jats:sup>\u22121<\/jats:sup> (or 100%). A review of the literature reveals a paucity of well constructed descriptive data quantifying the changes in coagulation that occur in response to surgical stress. The aim of this study was to quantify the changes in haemostatic variables occurring in response to elective orthopaedic surgery in normal individuals. Eligible subjects &gt;18\u00a0years of age undergoing total hip or knee replacement were recruited. Blood samples were drawn at five time points: baseline, preoperatively, 30\u00a0min after surgical incision, 30\u00a0min postoperatively, postoperative day (POD) 1. Analyses included t\u2010tests and repeated measures <jats:sc>anova<\/jats:sc>. Overall 30 patients, 21 women and 9 men, with a mean age of 65 were included in the final analysis. All von Willebrand factor (VWF) variables were seen to significantly decrease intraoperatively and increase postoperatively. VWF multimers showed a statistically significant decrease in high molecular weight multimers intraoperatively and an increase postoperatively. On subgroup analysis, age, gender and anaesthesia type were significantly correlated with changes in VWF parameters. Data presented in the current study establish a physiological baseline for VWF parameters in the normal population and demonstrate mean VWF\/factor VIII levels greater than 1.0\u00a0IU\u00a0mL<jats:sup>\u22121<\/jats:sup> intraoperatively. As such, current management in VWD patients does not appear to mimic the normal physiological response to surgery.<\/jats:p>","DOI":"10.1111\/hae.12185","type":"journal-article","created":{"date-parts":[[2013,5,28]],"date-time":"2013-05-28T08:23:07Z","timestamp":1369729387000},"page":"758-764","source":"Crossref","is-referenced-by-count":24,"title":["Quantification of perioperative changes in von Willebrand factor and factor VIII during elective orthopaedic surgery in normal individuals"],"prefix":"10.1111","volume":"19","author":[{"given":"A.","family":"Kahlon","sequence":"first","affiliation":[{"name":"Medicine, Kingston General Hospital Kingston ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Grabell","sequence":"additional","affiliation":[{"name":"Medicine, Kingston General Hospital Kingston ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Tuttle","sequence":"additional","affiliation":[{"name":"Medicine, Kingston General Hospital Kingston ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Engen","sequence":"additional","affiliation":[{"name":"Anesthesiology and Perioperative Medicine Kingston General Hospital Kingston ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Hopman","sequence":"additional","affiliation":[{"name":"Community Health and Epidemiology Queen's University and Clinical Research Centre Kingston General Hospital Kingston ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Lillicrap","sequence":"additional","affiliation":[{"name":"Pathology and Molecular Medicine Queen's University Kingston ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"James","sequence":"additional","affiliation":[{"name":"Medicine, Kingston General Hospital Kingston ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,5,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2007.01643.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2009.03661.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V69.2.454.454"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)80384-1"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1076029606296399"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V97.7.1915"},{"issue":"7","key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1056\/NEJMra040403","article-title":"Treatment of von Willebrand's Disease","volume":"351","author":"Mannucci PM","year":"2004","journal-title":"N Engl J Med"},{"issue":"3","key":"e_1_2_8_9_1","first-page":"378","article-title":"Venous thromboembolism in von Willebrand disease","volume":"88","author":"Mannucci PM","year":"2002","journal-title":"Thromb Haemost"},{"issue":"6","key":"e_1_2_8_10_1","first-page":"688","article-title":"Fainting induces an acute increase in the concentration of plasma factor VIII and von Willebrand factor","volume":"88","author":"Casonato A","year":"2003","journal-title":"Haematologica"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v11.i48.7639"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2007.03.007"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2006.01837.x"},{"issue":"2","key":"e_1_2_8_14_1","first-page":"s33","article-title":"Surgical prophylaxis in von Willedbrand's disease: a difficult balance to manage","volume":"6","author":"Franchini M","year":"2008","journal-title":"Blood Transfus"},{"key":"e_1_2_8_15_1","unstructured":"Clinical and Laboratory Standards Institute (formerly NCCLS).Assays of von Willebrand Factor Antigen and Ristocetin Cofactor Activity. Approved Guideline Document H51\u2010A 22 Number 20. 2002.1991."},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1655470"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1645215"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI109795"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1476-9255-7-2"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH09-06-0396"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2007.02588.x"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V99.2.450"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2008.01049.x"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-01-195313"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2010.02254.x"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2011.02534.x"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2012.02889.x"},{"key":"e_1_2_8_28_1","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1160\/TH05-01-0013","article-title":"Elevated factor VIII is a risk factor for idiopathic venous thromboembolism in Canada \u2013 is it necessary to define a new upper reference range for factor VIII?","volume":"93","author":"Wells PS","year":"2005","journal-title":"Thromb Haemost"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2012.02758.x"}],"container-title":["Haemophilia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fhae.12185","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hae.12185","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T13:09:39Z","timestamp":1696338579000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hae.12185"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,5,28]]},"references-count":28,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2013,9]]}},"alternative-id":["10.1111\/hae.12185"],"URL":"https:\/\/doi.org\/10.1111\/hae.12185","archive":["Portico"],"relation":{},"ISSN":["1351-8216","1365-2516"],"issn-type":[{"value":"1351-8216","type":"print"},{"value":"1365-2516","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,5,28]]}}}