Recombinant factor VIIa as last-resort treatment of desperate haemorrhage.
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
Ingimarsson, J P
Sigurdsson, G H
Onundarson, P T
MetadataShow full item record
CitationActa Anaesthesiol. Scand. 2012, 56(5):636-44
AbstractStudies are inconclusive regarding clinical outcomes after administration of recombinant activated coagulation factor VII (rFVIIa) during severe haemorrhage. The circumstances encountered during desperate haemorrhage make it difficult to include the most critically ill patients that could possibly benefit the most from such treatment into randomized controlled trials. We report our experience with rFVIIa as last-resort treatment of desperate haemorrhage when all standard treatment has failed. Hospital charts of all consecutive patients treated with rFVIIa for desperate non-haemophilic bleeding over a 10-year period at the single institution administering rFVIIa were surveyed for treatment indications, clinical outcome, transfusion need and coagulation profiles. Fifty-five rFVIIa treatment occasions of desperate bleeding were identified in 54 patients (median age 54 years). A single rFVIIa dose was used in 86%, and haemorrhage was considered effectively contained by immediate clinical response on 81% of occasions. Overall, 38 patients (71%) survived for over 30 days. Two thromboembolic events occurred (3.6%). The 24-h mortality in 45 rFVIIa immediate clinical responders and 10 non-responders was 2% and 50%, respectively (P = 0.0004), and the 30-day mortality was 25% and 60%, respectively (P = 0.05). Blood product use decreased with rFVIIa (P < 0.01) as did the prothrombin time (20.0-13.3 s, P < 0.0001). The majority of unselected consecutive patients receiving rFVIIa as last-resort treatment for desperate haemorrhage were considered to have immediate clinical response as well as reduced transfusion requirements and correction of coagulation parameters. An immediate clinical response to rFVIIa may possibly be predictive of survival.
DescriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links field.
RightsArchived with thanks to Acta anaesthesiologica Scandinavica
- Single-center experience: use of recombinant factor VIIa for acute life-threatening bleeding in children without congenital hemorrhagic disorder.
- Authors: Yilmaz D, Karapinar B, Balkan C, Akisü M, Kavakli K
- Issue date: 2008 Jun
- Low-dose recombinant factor VIIa for massive bleeding: a single centre observational cohort study with 73 patients.
- Authors: Schmid P, Mordasini A, Luginbühl M, Regli B, Kohler HP, Zimmermann H, Inderbitzin D, Hirt A, Lämmle B, Alberio L
- Issue date: 2011
- Off-label use of recombinant factor VIIa for treatment of haemorrhage: results from randomized clinical trials.
- Authors: Johansson PI
- Issue date: 2008 Jul
- Evaluation of recombinant factor VIIa treatment for massive hemorrhage in patients with multiple traumas.
- Authors: Koh YR, Cho SJ, Yeom SR, Chang CL, Lee EY, Son HC, Kim HH
- Issue date: 2012 Mar
- Recombinant activated factor VII in obstetric hemorrhage: experiences from the Australian and New Zealand Haemostasis Registry.
- Authors: Phillips LE, McLintock C, Pollock W, Gatt S, Popham P, Jankelowitz G, Ogle R, Cameron PA, Australian and New Zealand Haemostasis Registry.
- Issue date: 2009 Dec