title: Recombinant activated factor VII for hemorrhage after pediatric cardiac surgery.
abstract: Postoperative bleeding is a common complication after pediatric cardiac surgery. Use of recombinant activated factor VII for intractable hemorrhage after cardiac, pediatric, and neurosurgery has been shown to decrease postoperative bleeding, but data in children are limited. This retrospective study analyzed 20 children <15 years-old who underwent cardiac surgery and received recombinant activated factor VII for refractory postoperative hemorrhage. All patients underwent mediastinal reexploration before recombinant activated factor VII was administered as a bolus dose over 2-3 min as rescue therapy. If no significant decrease in chest tube drainage was observed, the dose was repeated after an interval of at least 2 h. The median dose of recombinant activated factor VII administered per bleeding episode was 83.33 μg·kg(-1) (range, 72.47-87.50 μg·kg(-1)), and the dose per patient was 154.16 μg·kg(-1) (range, 93.06-180.52 μg·kg(-1)). The median number of doses found to be effective in these children was 1.76. There were significant decreases in mediastinal chest tube drainage and the volume of packed red blood cells, platelet concentrates, and cryoprecipitate administered after recombinant activated factor VII. No complications were observed during the therapy.
authors.affiliation: Department of Cardiac Anesthesia, Cardio-Thoracic Sciences Center, All India Institute of Medical Sciences, New Delhi, India. sarveshpal.singh@gmail.com
authors.forename: Sarvesh Pal
authors.initials: SP
authors.lastname: Singh
authors.forename: Sandeep
authors.initials: S
authors.lastname: Chauhan
authors.forename: Minati
authors.initials: M
authors.lastname: Choudhary
authors.forename: Sumit
authors.initials: S
authors.lastname: Vasdev
authors.forename: Sachin
authors.initials: S
authors.lastname: Talwar
mesh_terms: D000293:Adolescent; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D015942:Factor VIIa / Q000008:administration & dosage / Q000235:genetics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019106:Postoperative Hemorrhage / Q000188:drug therapy*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D011994:Recombinant Proteins; D015942:Factor VIIa