Treatment of postoperative bleeding after fondaparinux with rFVIIa and tranexamic acid.
Treatment of a haemorrhagic shock after just a single dose of fondaparinux in an orthopaedic patient with reduced renal clearance is presented. Since all routine haemostatic parameters were nearly normal, single doses of rFVIIa (90 microg/kg) and of tranexamic acid (15 mg/kg) were administered to improve thrombin generation and reduce fibrinolysis. This case is the first showing the effectiveness of combining single doses of rFVIIa and tranexamic acid in controlling severe postoperative bleeding after fondaparinux.
Huvers
F
F
Department of Internal Medicine, Sint Maartenskliniek, Nijmegen, The Netherlands. F.Huvers@maartenskliniek.nl
Slappendel
R
R
Benraad
B
B
van Hellemondt
G
G
van Kraaij
M
M
D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip; D004359:Drug Therapy, Combination; D005167:Factor VII / Q000627:therapeutic use*; D015942:Factor VIIa; D005260:Female; D000077425:Fondaparinux; D006801:Humans; D007432:Intraoperative Period; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D011134:Polysaccharides / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000097:blood / Q000139:chemically induced / Q000188:drug therapy*; D011517:Prothrombin Time; D011994:Recombinant Proteins / Q000627:therapeutic use*; D014148:Tranexamic Acid / Q000627:therapeutic use*; D020246:Venous Thrombosis / Q000517:prevention & control
D000925:Anticoagulants; D000933:Antifibrinolytic Agents; D011134:Polysaccharides; D011994:Recombinant Proteins; D014148:Tranexamic Acid; D005167:Factor VII; C103587:recombinant FVIIa; D015942:Factor VIIa; D000077425:Fondaparinux