title: Recombinant factor VIIa use in patients presenting with intracranial hemorrhage.
abstract: Recombinant factor VIIa (rFVIIa) can be used for rapid INR normalization in life-threatening hemorrhage in anticoagulated patients. Dosing is unclear and may carry thromboembolic risks. We reviewed the use of rFVIIa at a comprehensive stroke and cerebrovascular center to evaluate dose effectiveness on INR reduction and thromboembolic complications experienced. The primary endpoint was to review the efficacy of rFVIIa in lowering INR. Secondary endpoints included doses used and adverse effects caused by rFVIIa administration. Forty-one percent of patients presented with a subdural hemorrhage. The mean INR prior to rFVIIa administration was 3.5 (0.9-15) and decreased to 1.13 (0.6-2). The mean dose of rFVIIa given was 73 mcg/kg (±24 mcg/kg). Two patients (3%) experienced a thromboembolic event. Recombinant factor VIIa appears to lower INR without significant thromboembolic complications.
authors.affiliation: Department of Pharmacy, Capital Health Regional Medical Center, 750 Brunswick Ave, Trenton, NJ 08534 USA.
authors.forename: Natalie
authors.initials: N
authors.lastname: Yampolsky
authors.affiliation: Department of Neurosurgery, Capital Institute for Neurosciences, Trenton, NJ USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Stofko
authors.affiliation: Department of Neurosurgery, Capital Institute for Neurosciences, Trenton, NJ USA.
authors.forename: Erol
authors.initials: E
authors.lastname: Veznedaroglu
authors.affiliation: Department of Neurosurgery, Capital Institute for Neurosciences, Trenton, NJ USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Liebman
authors.affiliation: Department of Neurosurgery, Capital Institute for Neurosciences, Trenton, NJ USA.
authors.forename: Mandy J
authors.initials: MJ
authors.lastname: Binning
keywords: Anticoagulation; International Normalized Ratio; Intracranial hemorrhage; Neurosurgery; Recombinant factor VIIa; Stroke