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Recombinant activated factor VII in controlling bleeding in non-hemophiliac patients
BACKGROUND: There have been recent reports on the successful use of recombinant factor VIIa (rFVIIa) in non-hemophiliac patients who have experienced heavy blood loss due to trauma with extensive organ damage and who have received multiple blood transfusions with hemostatic changes without success....
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Formato: | Texto |
Lenguaje: | English |
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Medknow Publications
2010
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886869/ https://www.ncbi.nlm.nih.gov/pubmed/20427935 http://dx.doi.org/10.4103/0256-4947.62830 |
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author | AlGahtani, Farjah H. Alshaikh, Mashael AlDiab, AbdulRehman |
author_facet | AlGahtani, Farjah H. Alshaikh, Mashael AlDiab, AbdulRehman |
author_sort | AlGahtani, Farjah H. |
collection | PubMed |
description | BACKGROUND: There have been recent reports on the successful use of recombinant factor VIIa (rFVIIa) in non-hemophiliac patients who have experienced heavy blood loss due to trauma with extensive organ damage and who have received multiple blood transfusions with hemostatic changes without success. The timing of administration, dosage, mortality, units of blood transfusion saved, risk of thrombotic events, and the risk/benefit ratio are still poorly defined. PATIENTS AND METHODS: We conducted a retrospective review of all medical records of patients who received rFVIIa between January 2003 and March 2008. Data collection included demographic characteristics, diagnosis, indications, comorbidities, and amount of blood products used with rFVIIa, dose of rFVIIa, mortality, and adverse events. RESULTS: We identified 45 patients, 27 (60%) males and 18 (40%) females, with a median age of 52 years. The median dose of rFVIIa was 40 μg/kg (range, 20-120 μg/kg). Five (11.1%) patients needed a second dose of rFVIIa (dose range of 20-85 μg/kg) whereas three patients (6.7%) needed a third dose of rFVIIa (dose range of 40-60 μg/kg). There was a marked and significant reduction in transfusion requirements for packed red blood cells (P=.0078). Overall transfusion requirements significantly decreased after the infusion of rFVIIa (P=.0323). Nineteen patients (42.2%) died and thrombosis was documented in 3 patients (6.7%). CONCLUSION: Use of rFVIIa should be based on sound clinical evidence to balance the risks, benefits, and cost if used among non-hemophiliacs. Prospective randomized studies are needed to investigate the efficacy and cost-effectiveness of rFVIIa for this indication and to allow a final assessment of the importance of this treatment. |
format | Text |
id | pubmed-2886869 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | Medknow Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-28868692010-07-02 Recombinant activated factor VII in controlling bleeding in non-hemophiliac patients AlGahtani, Farjah H. Alshaikh, Mashael AlDiab, AbdulRehman Ann Saudi Med Original Article BACKGROUND: There have been recent reports on the successful use of recombinant factor VIIa (rFVIIa) in non-hemophiliac patients who have experienced heavy blood loss due to trauma with extensive organ damage and who have received multiple blood transfusions with hemostatic changes without success. The timing of administration, dosage, mortality, units of blood transfusion saved, risk of thrombotic events, and the risk/benefit ratio are still poorly defined. PATIENTS AND METHODS: We conducted a retrospective review of all medical records of patients who received rFVIIa between January 2003 and March 2008. Data collection included demographic characteristics, diagnosis, indications, comorbidities, and amount of blood products used with rFVIIa, dose of rFVIIa, mortality, and adverse events. RESULTS: We identified 45 patients, 27 (60%) males and 18 (40%) females, with a median age of 52 years. The median dose of rFVIIa was 40 μg/kg (range, 20-120 μg/kg). Five (11.1%) patients needed a second dose of rFVIIa (dose range of 20-85 μg/kg) whereas three patients (6.7%) needed a third dose of rFVIIa (dose range of 40-60 μg/kg). There was a marked and significant reduction in transfusion requirements for packed red blood cells (P=.0078). Overall transfusion requirements significantly decreased after the infusion of rFVIIa (P=.0323). Nineteen patients (42.2%) died and thrombosis was documented in 3 patients (6.7%). CONCLUSION: Use of rFVIIa should be based on sound clinical evidence to balance the risks, benefits, and cost if used among non-hemophiliacs. Prospective randomized studies are needed to investigate the efficacy and cost-effectiveness of rFVIIa for this indication and to allow a final assessment of the importance of this treatment. Medknow Publications 2010 /pmc/articles/PMC2886869/ /pubmed/20427935 http://dx.doi.org/10.4103/0256-4947.62830 Text en © Annals of Saudi Medicine http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article AlGahtani, Farjah H. Alshaikh, Mashael AlDiab, AbdulRehman Recombinant activated factor VII in controlling bleeding in non-hemophiliac patients |
title | Recombinant activated factor VII in controlling bleeding in non-hemophiliac patients |
title_full | Recombinant activated factor VII in controlling bleeding in non-hemophiliac patients |
title_fullStr | Recombinant activated factor VII in controlling bleeding in non-hemophiliac patients |
title_full_unstemmed | Recombinant activated factor VII in controlling bleeding in non-hemophiliac patients |
title_short | Recombinant activated factor VII in controlling bleeding in non-hemophiliac patients |
title_sort | recombinant activated factor vii in controlling bleeding in non-hemophiliac patients |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886869/ https://www.ncbi.nlm.nih.gov/pubmed/20427935 http://dx.doi.org/10.4103/0256-4947.62830 |
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