Rescue treatment with recombinant factor VIIa is effective in patients with life-threatening bleedings secondary to major wound excision: a report of four cases.
Major burn wound excision is associated with excessive perioperative blood loss. Treatment of massive microvascular bleeding represents a special problem in the burn setting, characterized by extensive damage at the capillary level, and resulting in a profound blood loss; which together with the consumptive states makes adequate replacement therapy with coagulation factors and platelets difficult. We described our experience with rescue treatment with rFVIIa in four patients undergoing major wound excision, developing life-threatening perioperative bleeding, and not responding to conventional therapy. Hemostasis was achieved within 15 minutes of intravenous rFVIIa administration, at a dose of 100 microg/kg, in all patients. No treatment-related adverse events, in particular, no thromboembolic events were observed. We conclude that rFVIIa may be an effective hemostatic treatment for patients undergoing major wound excision developing life-threatening bleedings.
Johansson
Pär I
PI
Department of Clinical Immunology, University Hospital of Copenhagen, Copenhagen, Denmark. p.johansson@post.tele.dk
Eriksen
Kirsten
K
Alsbjørn
Bjarme
B
D000328:Adult; D002056:Burns / Q000601:surgery*; D002648:Child; D005167:Factor VII / Q000627:therapeutic use*; D015942:Factor VIIa; D006470:Hemorrhage / Q000188:drug therapy*; D006801:Humans; D007431:Intraoperative Complications / Q000188:drug therapy*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use
D011994:Recombinant Proteins; D005167:Factor VII; C103587:recombinant FVIIa; D015942:Factor VIIa