Recombinant activated factor VII in the treatment of near-fatal bleeding during pediatric brain tumor surgery. Report of two cases and review of the literature.
Recombinant activated factor VII (rFVIIa) was successfully used in two pediatric cases to control microvascular bleeding during brain tumor surgery. The agent demonstrated a marked effect on the intraoperative blood coagulation after failure of conventional therapy with fresh-frozen plasma, platelet concentrates, and inhibition of the fibrinolytic system. Remarkably, rFVIIa was effective in the present cases in which assessment of hemostasis yielded normal results. The use of rFVIIa should be considered in otherwise untreatable microvascular bleeding in pediatric neurosurgery.
Hartmann
Matthias
M
Department of Anesthesiology, and Institute for Hemostasis and Transfusion Medicine, University Hospital Düsseldorf, Germany. matthias.hartmann@uni-duesseldorf.de
Sucker
Christoph
C
Messing
Martina
M
D000293:Adolescent; D001932:Brain Neoplasms / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D002648:Child; D015942:Factor VIIa / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D011994:Recombinant Proteins / Q000627:therapeutic use; D016896:Treatment Outcome
D011994:Recombinant Proteins; D015942:Factor VIIa