title: [The role of recombinant activated factor VII in neuro- surgical and neurocritical patients].
abstract: Central nervous system haemorrhage is a severe pathology, as a small amount of bleeding inside the brain can result in devastating consequences. Haemostatic agents might decrease the consequences of intra- cranial bleeding, whichever spontaneous, traumatic, or anticoagulation treatment etiology. Proacogulant recombinant activated factor VII (rFVIIa) has been given after central nervous system bleeding, with an off-label indication. In this update, we go over the drug mechanism of action, its role in the treatment of central nervous system haemorrhage and the published evidences regarding this subject. We carried out a literature review concerning the treatment with rFVIIa in central nervous system haemorrhage, neurocritical pathologies and neurosurgical procedures, searching in MEDLINE and in clinical trials registry: http://clinicaltrials.gov (last review September 2010), as well as performing a manual analysis of collected articles, looking for aditional references. The results of randomized clinical trials do not support the systematic administration of rFVIIa for spontaneous intracranial cerebral haemorrhage. In other central nervous system related haemorrhages, the current available data consist on retrospective studies, expert opinion or isolated case reports.
authors: Servicio de Anestesiología y Reanimación. Complejo Hospitalario Universitario A Coruña. prmaceiras@wanadoo.es
authors: P
authors: P
authors: Rama-Maceiras
authors: I
authors: I
authors: Ingelmo-Ingelmo
authors: N
authors: N
authors: Fábregas-Juliá
authors: J
authors: J
authors: Hernández-Palazón
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects; D001777:Blood Coagulation / Q000187:drug effects / Q000502:physiology; D001778:Blood Coagulation Disorders / Q000150:complications; D001930:Brain Injuries / Q000150:complications; D002543:Cerebral Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D057176:Compassionate Use Trials; D003362:Cost-Benefit Analysis; D003422:Critical Care; D015942:Factor VIIa / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000502:physiology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D019635:Neurosurgical Procedures; D056687:Off-Label Use; D011183:Postoperative Complications / Q000188:drug therapy*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy
chemical_list: D000925:Anticoagulants; D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa