The use of recombinant activated factor VII to control bleeding in a preterm infant undergoing exploratory laparotomy.
The case of a preterm infant weighing 1120 g who successfully received recombinant activated factor VII (rFVIIa) without complication for control of a life-threatening bleeding event resulting from a ruptured umbilical artery is reported. After performing an exploratory laparotomy at 27 hours of age, hemorrhage from the surgical wound and various sites persisted. By 63 hours of age, the infant had received a total of 192 mL (171 mL/kg) of packed red blood cells, 115 mL (103 mL/kg) of fresh frozen plasma, 8 mL of cryoprecipitate, and 75 mL (67 mL/kg) of platelet concentrate without stabilization. Hemorrhage ceased after 2 doses of 40 microg/kg/dose recombinant activated factor VII given at 63 and 70 hours of age, with subsequent stabilization of the hematocrit and without need for additional transfusion therapy.
Chuansumrit
Ampaiwan
A
Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. raajs@mahidol.ac.th
Nuntnarumit
Pracha
P
Okascharoen
Chusak
C
Teeraratkul
Sumete
S
Suwansingh
Saranya
S
Supapannachart
Sarayut
S
D001778:Blood Coagulation Disorders / Q000175:diagnosis / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005167:Factor VII / Q000008:administration & dosage / Q000627:therapeutic use*; D015942:Factor VIIa / Q000008:administration & dosage / Q000627:therapeutic use; D006406:Hematoma / Q000175:diagnosis; D006470:Hemorrhage / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000188:drug therapy*; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use*; D012187:Retroperitoneal Space; D014469:Umbilical Arteries / Q000187:drug effects
D011994:Recombinant Proteins; D005167:Factor VII; C103587:recombinant FVIIa; D015942:Factor VIIa