Recombinant factor VIIa for the treatment of severe postoperative and traumatic hemorrhage.
BACKGROUND
The aim of this study was to determine the dose of recombinant factor VIIa (rFVIIa) that has been used in our institution to successfully control hemorrhage in trauma and postoperative patients.


METHODS
This was an 8-month retrospective cohort study of 13 patients with acute hemorrhage and no known history of coagulopathic disorders.


RESULTS
Administration of factor VIIa resulted in the cessation of life-threatening hemorrhage at dosages approximately one half those recommended for the management of hemophilia. After administration, there was a significant decrease in the total blood-product transfusion requirement (P <0.05).


CONCLUSIONS
The use of factor VIIa in patients with life-threatening hemorrhage is a safe and effective therapeutic modality when used as an adjunct to standard interventions for control of severe hemorrhage. Lower-dose regimens were as successful as higher-dose regimens previously reported. The results of this respective study of 13 patients suggests that recombinant factor VIIa therapy for control of life-threatening hemorrhage as an adjunct to standard interventions can be successful at doses <90 mg/kg.
Khan
A Zaman
AZ
Grand Rapids/Michigan State University General Surgery Residency, Grand Rapids Medical Education and Research Center for the Health Professions, 221 Michigan St. NE, Suite 200A, Grand Rapids, MI 49502, USA. khanofbannu@hotmail.com
Parry
J Michael
JM
Crowley
William F
WF
McAllen
K
K
Davis
Alan T
AT
Bonnell
Bruce W
BW
Hoogeboom
James E
JE
D000328:Adult; D001780:Blood Coagulation Tests; D001803:Blood Transfusion; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D005167:Factor VII / Q000008:administration & dosage*; D015942:Factor VIIa; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D019106:Postoperative Hemorrhage / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D011994:Recombinant Proteins / Q000008:administration & dosage*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014947:Wounds and Injuries / Q000150:complications
D006454:Hemoglobins; D006490:Hemostatics; D011994:Recombinant Proteins; D005167:Factor VII; C103587:recombinant FVIIa; D015942:Factor VIIa