title: Factor IX complex for the treatment of severe bleeding after cardiac surgery.
abstract: BACKGROUND
  Previous reports have been published on the use of recombinant Factor VIIa for intractable bleeding after cardiac surgery; however, there is limited information on the use of Factor IX Complex in this population.
  
  
  METHODS
  A retrospective cohort study of adult patients who underwent cardiac surgery and experienced severe postoperative bleeding, defined as a mean chest tube output ≥300 mL/h. Primary outcomes were changes in chest tube output and blood product usage pre- and post-Factor IX Complex administration.
  
  
  RESULTS
  Eleven patients received Factor IX Complex for severe postoperative bleeding. The mean dose of Factor IX Complex was 35 (13-52) units/kg. Chest tube output was significantly reduced after Factor IX Complex administration (mean pre-Factor IX Complex 381 ± 49 mL/h, mean post-Factor IX Complex 151 ± 38 mL/h; P = 0.003). Blood product usage decreased after Factor IX Complex but was not statistically significant (mean pre-Factor IX Complex 373 ± 81 mL/h, mean post-Factor IX Complex 212 ± 48 mL/h; P = 0.669). Adverse events included 1 pulmonary embolism (postoperative day 43) and 2 episodes of acute renal failure requiring dialysis (postoperative days 2 and 5).
  
  
  CONCLUSIONS
  In this small group of patients, Factor IX Complex effectively controlled severe bleeding after cardiac surgery preventing the need for re-exploration.
authors.affiliation: Department of Pharmacy, Wake Forest Baptist Health Medical Center Boulevard, Winston Salem, NC, USA. kbclark@ghs.org
authors.forename: Kimberly B
authors.initials: KB
authors.lastname: Clark
authors.forename: Neal D
authors.initials: ND
authors.lastname: Kon
authors.forename: John W
authors.initials: JW
authors.lastname: Hammon
authors.forename: Drew A
authors.initials: DA
authors.lastname: MacGregor
authors.forename: Edward H
authors.initials: EH
authors.lastname: Kincaid
authors.forename: Marc G
authors.initials: MG
authors.lastname: Reichert
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000188:drug therapy; D006348:Cardiac Surgical Procedures; D015505:Chest Tubes; D050792:Circulatory Arrest, Deep Hypothermia Induced; D015331:Cohort Studies; D001026:Coronary Artery Bypass; D005164:Factor IX / Q000627:therapeutic use; D011183:Postoperative Complications / Q000188:drug therapy; D019106:Postoperative Hemorrhage / Q000188:drug therapy; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000933:Antifibrinolytic Agents; D005164:Factor IX; D011994:Recombinant Proteins