Recombinant activated factor VII for the treatment of life-threatening haemorrhage.
To describe the use of recombinant activated factor VII (rFVIIa) in patients with life-threatening haemorrhage. We report a case series of Australian patients with life-threatening haemorrhage who were treated with rFVIIa prior to August 2002 namely 21 patients, median age 45 years (range 22-79 years), 33% (seven of 21) female. The major causes for bleeding were multi-trauma, cardiac or vascular surgery, or orthoptic liver transplantation. In the 24 h prior to the administration of rFVIIa, the median blood usage was 22 U packed cells (range 3-66 U), the median International Normalized Ratio was 1.6 (range 1.4-3.6) and the median activated partial thromboplastin time was 55 s (range 31-180 s). During the 24 h after administration of rFVIIa, the median blood usage was 2 U packed cells (range 0-16 U), the median International Normalized Ratio was 1.0 (range 0.9-1.2) and the median activated partial thromboplastin time was 40 s (range 30-94 s); P < 0.001 for each comparison. Sixteen of the 21 patients were discharged from hospital or were alive at 30 days. There were no thrombotic complications following the administration of rFVIIa. These uncontrolled data suggest a role for rFVIIa as an adjunctive haemostatic measure in surgical patients with life-threatening haemorrhage for whom conventional measures to achieve haemostasis have failed.
Eikelboom
John W
JW
Department of Haematology, Royal Perth Hospital and School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia. john.eikelboom@health.wa.gov.au
Bird
Robert
R
Blythe
David
D
Coyle
Luke
L
Gan
Eng
E
Harvey
Michael
M
Isbister
James
J
Leahy
Michael
M
McIlroy
David
D
Rahimpanah
Farhad
F
Ramanthan
Sundra
S
Strasser
Simone
S
Ward
Chris
C
Watts
Andrew
A
Towler
Simon
S
Yi
Qilong
Q
D000328:Adult; D000368:Aged; D001778:Blood Coagulation Disorders / Q000188:drug therapy / Q000209:etiology; D005167:Factor VII / Q000627:therapeutic use*; D015942:Factor VIIa; D005260:Female; D006470:Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011994:Recombinant Proteins / Q000627:therapeutic use*
D011994:Recombinant Proteins; D005167:Factor VII; C103587:recombinant FVIIa; D015942:Factor VIIa