Recombinant factor VII (activated) for haemorrhagic complications of severe sepsis treated with recombinant protein C (activated).
We report on 2 cases of severe sepsis treated with drotrecogin-alpha (Xigris, Eli Lilly), where massive perioperative haemorrhage required administration of recombinant factor VIIa. The first patient developed severe sepsis after surgery (laparoscopic cholecystectomy, laparotomy due to peritonitis). After 18 h of treatment with Xigris, the patient developed massive, refractory gastrointestinal and abdominal bleeding. Effective haemostasis was achieved after 2 doses of NovoSeven (Novo Nordisk, Denmark). The patient died due to a cerebral bleed. The second patient developed septic shock in the course of pyelonephritis and right hydronephrosis. She was treated with Xigris and nephrectomy. Uncontrollable perioperative bleeding was effectively treated with 2 doses of NovoSeven. The patient survived.
Michalska-Krzanowska
Grazyna
G
Department of Anaesthesiology and Intensive Care, Clinical Hospital No. 2, Szczecin, Poland. grazyna195@op.pl
Czupryńska
Maria
M
D000328:Adult; D005169:Factor VIII / Q000627:therapeutic use*; D015942:Factor VIIa / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D011486:Protein C / Q000009:adverse effects*; D011994:Recombinant Proteins / Q000009:adverse effects*; D018805:Sepsis / Q000150:complications* / Q000188:drug therapy
D011486:Protein C; D011994:Recombinant Proteins; C078147:F8 protein, human; D005169:Factor VIII; D015942:Factor VIIa