Continuous infusion of recombinant factor VIIa for surgery in patients with deficiency of factor VII.
The administration of recombinant activated factor VII (rFVIIa) by continuous infusion has provided a safe and convenient alternative to bolus injections in haemophiliacs with inhibitors, but it has only been reported in a single case with congenital factor VII (FVII) deficiency. The results of 12 consecutive surgical procedures in 7 patients with congenital FVII deficiency are reported here. rFVIIa was always given in continuous infusion,aiming at plasma FVII activity of 0.5 IU/mL. Treatment was given for 2 to 7 days with a mean total dose of 7.8 mg rFVIIa. Blood loss was as expected from the different types of procedures and the only thromboembolic complication was a superficial thrombophlebitis at the infusion site. This mode of substitution was therefore safe, effective and well tolerated.
Schulman
Sam
S
Coagulation Unit, Department of Haematology, Karolinska University Hospital, Stockholm, Sweden. schulms@mcmaster.ca
Tjønnfjord
Geir E
GE
Wallensten
Richard
R
Martinowitz
Uri
U
Kenet
Gill
G
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005168:Factor VII Deficiency / Q000097:blood / Q000188:drug therapy*; D015942:Factor VIIa / Q000008:administration & dosage* / Q000493:pharmacokinetics; D005260:Female; D006488:Hemostasis, Surgical; D006490:Hemostatics / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage* / Q000493:pharmacokinetics; D013514:Surgical Procedures, Operative
D006490:Hemostatics; D011994:Recombinant Proteins; D015942:Factor VIIa