title: Recombinant-activated factor VII in the paediatric cardiac surgery: single unit experience.
abstract: BACKGROUND
  The control of excessive bleeding after paediatric cardiac surgery can be challenging. This may make the use of recombinant-activated factor VII (rFVIIa) in preventing this excessive bleeding, after adopted conventional methods have failed, desirable. Our aim is to highlight our experience with the use of rFVIIa in preventing excessive bleeding after paediatric cardiac surgery.
  
  
  METHODS
  The data for 14 patients who had rFVIIa for excessive haemorrhage after cardiac surgery from December 2009 to November 2010 was analysed. The perioperative blood loss from the chest drain before and after the administration of rFVIIa, use of blood products, international normalized ratio (INR) and activated partial thromboplastin (aPTT), before and after administration of rFVIIa, were analysed.
  
  
  RESULTS
  The rFVIIa was successful in stopping bleeding in all the patients. The mean coagulation factors before rFVIIa were as follows: INR, 2.88 (1.82-4.5); aPTT, 65 seconds (33.4-95.1); after rFVIIa, the mean INR was 1.2 (0.82-1.56), mean APTT was 38.7 seconds (25.6-54.9). No thromboembolic events or allergic reactions or deaths were recorded.
  
  
  CONCLUSIONS
  rFVIIa use is not only effective in stopping excessive perioperative bleeding but also safe and indirectly reduces transfusion of blood and its products.
authors.affiliation: Department of Cardiac Surgery, Institute of Cardiovascular Diseases, The Madras Medical Mission, Chennai, India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Agarwal
authors.forename: Kelechi E
authors.initials: KE
authors.lastname: Okonta
authors.forename: Praveen S
authors.initials: PS
authors.lastname: Lal
mesh_terms: D000293:Adolescent; D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D015942:Factor VIIa / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010314:Partial Thromboplastin Time; D019106:Postoperative Hemorrhage / Q000097:blood / Q000517:prevention & control*; D011994:Recombinant Proteins / Q000008:administration & dosage; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa