title: Use of recombinant activated factor VII to arrest uncontrolled bleeding: a case series.
abstract: A retrospective analysis is described to assess the effects of using recombinant activated factor VII to control bleeding in a series of patients who had failed to respond to conventional hemostatic measures. In all, 18 patients (aged 16-65 years) with a range of conditions resulting in bleeding refractory to conventional methods of control were treated with recombinant activated factor VII (60-120 Amicrog/kg; 1-4 doses). The effects of recombinant activated factor VII on bleeding were noted together with the patients' transfusion requirements and hematological parameters. Administration of recombinant activated factor VII successfully stopped bleeding in 17 of the 18 patients. Therapy with recombinant activated factor VII significantly decreased transfusion requirements for packed red blood cells, fresh frozen plasma, platelets, and cryoprecipitate compared with pretreatment values along with significant improvement in hemostasis. In various serious bleeding situations, treatment with recombinant activated factor VII may effectively arrest bleeding, which has remained refractory to conventional methods of control.
authors.affiliation: Faculty of Medicine, Kuwait University, and Department of Medicine, Mubarak Al-Kabeer Hospital.
authors.forename: Faisal
authors.initials: F
authors.lastname: Alsayegh
authors.forename: Aisha
authors.initials: A
authors.lastname: Fakeir
authors.forename: Salah
authors.initials: S
authors.lastname: Alhumood
authors.forename: Kefaya
authors.initials: K
authors.lastname: Abdumalek
authors.forename: Hatem
authors.initials: H
authors.lastname: Matar
authors.forename: Isaac
authors.initials: I
authors.lastname: Samaul
authors.forename: Narayanan
authors.initials: N
authors.lastname: Nampoory
authors.forename: Housam
authors.initials: H
authors.lastname: Kabalawi
authors.forename: Shaker A
authors.initials: SA
authors.lastname: Mousa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001777:Blood Coagulation / Q000187:drug effects / Q000502:physiology; D001803:Blood Transfusion; D015942:Factor VIIa / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D006487:Hemostasis; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000097:blood / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications; D055815:Young Adult
chemical_list: D006490:Hemostatics; D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa