RESEARCH PAPER
Recombinant factor VIIa in the management of postoperative bleeding in patients undergoing reconstruction of ruptured abdominal aortic aneurysm
1
Chair and Department of Vascular Surgery and Angiology, Medical University, Lublin, Poland
Corresponding author
Piotr Terlecki
Terlecki, Chair and Department of Vascular Surgery and Angiology, Medical University, Jaczewskiego 8, 20-090 Lublin, Poland.
Terlecki, Chair and Department of Vascular Surgery and Angiology, Medical University, Jaczewskiego 8, 20-090 Lublin, Poland.
J Pre Clin Clin Res. 2009;3(1):58-60
KEYWORDS
ABSTRACT
Recombinant activated factor VIIa (rFVIIa) (NovoSeveNovoNordisk, Bagsvaerd, Denmark) is a well-known haemostatic agent indicated for control of bleeding in patients with severe bleeding associated with hemophilia, thrombocytopenia and disseminated intravascular coagulation. The surgical literature increasingly reports the off -licence administration of rFVIIa to arrest haemorrhage refractory in other interventions. It has been successfully used to control peri-operative bleeding in trauma, cardio-vascular and neurosurgical patients. We report 10 cases of previously healthy males, without preexisting coagulopathy, who had undergone surgical procedure because of a ruptured infrarenal aortic aneurysm. Despite the administration of red blood cell concentrate, fresh frozen plasma and platelets specimens in the peri- and post-operative period, the patients were unstable and presented non-surgical bleeding. Intravenous treatment with rFVIIa was used in two doses (37-90 μg/kg) every 2 hours. In all cases, bleeding stopped. Two patients died in the period of 72 hours after operation because of multiple organ failure, a third died one month later because of myocardial infarction. We conclude that treatment with Recombinant Activated Factor VIIa for patients undergoing AAA reconstruction complicated with non-surgical, life-threatening bleeding, seems to be effective and safe.
REFERENCES (21)
1.
Aldouri M: The use of recombinant factor VIIa in controlling surgical bleeding in non-haemophiliac patients. Pathophysiol Haemost Thromb 2002, 32(Suppl. 1), 41-46.
2.
Warren OJ, Alcock EM, Choong AM, Leff DR, van Herzeele I, Darzi AW, Athanasiou T, Cheshire NJ: Recombinant activated factor VII: a solution to refractory haemorrhage in vascular surgery? Eur J Vasc Endovasc Surg 2008, 35, 145-152.
3.
Clark AD, Gordon WC, Walker ID, Tait RC: Last-ditch use of recombinant factor VIIa in patients with massive haemorrhage is ineff ective. Vox Sang 2004, 86(2),120-124.
4.
del Pozo Pozo AI, Jimenez -Yiste V, Villar A, Quintana M, Hernaandez- Navarro F: Successful thyreidectomy in a patient with Hermansky- Pudlak syndrome treated with recombinant activated factor VII and platelet concentrates. Blood Coagul Fibrinolysis 2002, 13, 551-553.
5.
Friederich PW, Henny CP, Masselink EJ, Geerdink MG, Keller T, Kurth KH, Buller HR, Levi M: Eff ect of recombinant factor VII on perioperative blood loss in patients undergoing retropubic prostatectomy: a doubleblind placebo-controlled randomised trial. Lancet 2003, 361, 201- 205.
6.
Goodnough LT, Lublin DM, Zhang L, Despotis G, Eby C: Transfusion medicine service policies for recombinant factor VIIa administration. Transfusion 2004, 44(9), 1325-1331.
7.
Grounds RM, Seebach C, Knothe C, Paluszkiewicz P, Smith TS, Kasal E, Lecumberri L, Urbanec R, Haas T, Wujtewicz M, Rehorkova D, Pelichovska M, Lange M, Uranga M, Bosman R, Rommes JH, Koscielny J: Use of recombinant activated factor VII (NovoSeven) in trauma and surgery: analysis of outcomes reported to an international registry. J Intensive Care Med 2006, 21(1), 27-39.
8.
Hedner U, Glazer S, Pingel K, Alberts KA, Blomback M, Schulman S, Johnsson H: Successful use of recombinant factor VIIa in patients with severe haemophilia A during synovectomy. Lancet 1998, 2(8621), 1193.
9.
Liem AK, Biesma DH, Ernst SM, Schepens AA: Recombinant activated factor VII for false aneurysm in patients with normal haemostatic mechanisms. Thromb Haemost 1999, 82(1), 150-151.
10.
Mohr AM, Holcomb JB, Dutton RP, Duranteau J: Recombinant activated factor VIIa and hemostasis in critical care: a focus on trauma. Crit Care 2005, 9(Suppl. 5), 37-42.
11.
O’Connell KA, Wood JJ, Wise RP, Lozier JN, Braun MM: Thromboembolic adverse events after use of recombinant human coagulation factor VIIa. JAMA 2006, 295(3), 293-298.
12.
Pugh RJ, Wenstone R, Martlew VJ, Marx G: Use of recombinant factor VIIa for major haemorrhage. Eur J Anaesthesiol 2005, 22(7), 548- 550.
13.
Raobaikady R, Redman J, BAll JA, Maloney G, Grounds RM: Use of activated recombinant coagulation factor VII in patients undergoing reconstruction surgery for traumatic fracture of pelvis or pelvis and acetabulum: a double-blind, randomized, placebo- controlled trial. Br J Anaesth 2005, 94(5), 586-591.
14.
Shander A, Goodnough LT: Consensus recommendations for the off - label use of recombinant human factor VIIa (Novo Seven) therapy. Pharma Ther 2005, 30, 644-658.
15.
Slappendel R, Huvers FC, Benraad B, Novakova I, van Hellemondt GG: Use of recombinant factor VIIa (Novo Seven) to reduce postoperative bleeding after totalhip arthroplasty in a patient with cirrhosis and thrombocytopenia. Anastesiology 2002, 96, 1525-1527.
16.
Tobias JD: Synthetic factor VIIa to treat dilutional coagulopathy during posterior spinal fusion in two children. Anesthesiology 2002, 96,1522- 1525.
17.
Tawfi ck WA., Tawfi k S, Hynes N, Mahendran B, Sultan S: Critical bleeding in vascular surgery: expanding the indication of recombinant activated factor VII. Vascular 2006, 14(1), 32-37.
18.
Wahlgren CM, Swedenborg J: The use of recombinant activated factor VII to control bleeding during repair of suprarenal abdominal aortic aneurysm. Eur J Vasc Endovasc Surg 2003, 26(2), 221-222.
19.
Warren O, Mandal K, Hadjianastassiou V, Knowlton L, Panesar S, John K, Darzi A, Athanasiou T: Recombinant activated factor VII in cardiac surgery: a systematic review. Ann Thorac Surg 2007, 83(2), 707-714.
20.
O’Connell KA, Wood JJ, Wise RP, Lozier JN, Braun MM: Thrombotic adverse events after use of recombinant human coagulation factor VIIa. JAMA 2006, 295(3), 293-298.
21.
Diringer MN, Skolnick BE, Mayer SA, Steiner T, Davis SM, Brun NC, Broderick JP: Risk of thromboembolic events in controlled trials of rFVIIa in spontaneous intracerebral hemorrhage. Stroke 2008, 39, 850-856.
| eISSN: | 1898-7516 |
| ISSN: | 1898-2395 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
