Use of Low-Dose Recombinant Factor Ⅶa for Uncontrolled Perioperative Bleeding
Background: Recombinant activated factor VIIa (rFVIIa) is a prohemostatic agent initially approved for use in hemophilia patients and has also been used for a diverse range of off-label indications in the context of massive uncontrolled blood loss; however, no convincing evidence exists regarding th...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2020-11-01
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| Series: | Dose-Response |
| Online Access: | https://doi.org/10.1177/1559325820969569 |
| _version_ | 1818347210919641088 |
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| author | Zhi-gang Chang MD, PhD Xin Chu MD Wen Chen MD Jun-hua Hu MD Ji-wu Gong MD Da-dong Liu MD Qing He MD Zhe Feng MD Shi-rou Xiao MD Ya-lin Liu MD |
| author_facet | Zhi-gang Chang MD, PhD Xin Chu MD Wen Chen MD Jun-hua Hu MD Ji-wu Gong MD Da-dong Liu MD Qing He MD Zhe Feng MD Shi-rou Xiao MD Ya-lin Liu MD |
| author_sort | Zhi-gang Chang MD, PhD |
| collection | DOAJ |
| description | Background: Recombinant activated factor VIIa (rFVIIa) is a prohemostatic agent initially approved for use in hemophilia patients and has also been used for a diverse range of off-label indications in the context of massive uncontrolled blood loss; however, no convincing evidence exists regarding the optimal dose of rFVIIa to treat uncontrolled bleeding in surgical patients. Aim: To evaluate the effects and safety of a very low dose of rFⅦa in patients with uncontrolled perioperative bleeding in the surgical intensive care unit (ICU). Methods: 55 patients from Beijing Hospital, who received rFⅦa between July 2004 and November 2018 for uncontrolled perioperative bleeding were included. The controls were matched for age, sex, severity, and operation type. The baseline demographics, survival, changes in bleeding and transfusion, coagulation parameters and complications were analyzed. Results: A low dose of rFⅦa (2.0∼3.6 mg, with a median dose of 39.02 μg/kg) appears to be effective in controlling massive hemorrhage (with an effective rate of 74.55%), and can reduce volume of red blood cell transfusion, improve coagulation status, while has a relatively low risk of thromboembolic complications (3.6%). Conclusion: In patients with uncontrolled perioperative bleeding, a low dose of rFⅦa could be used when traditional methods are ineffective. |
| first_indexed | 2024-12-13T17:30:33Z |
| format | Article |
| id | doaj.art-677e80f8875e4f9faae8fa9ece252640 |
| institution | Directory Open Access Journal |
| issn | 1559-3258 |
| language | English |
| last_indexed | 2024-12-13T17:30:33Z |
| publishDate | 2020-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Dose-Response |
| spelling | doaj.art-677e80f8875e4f9faae8fa9ece2526402022-12-21T23:37:03ZengSAGE PublishingDose-Response1559-32582020-11-011810.1177/1559325820969569Use of Low-Dose Recombinant Factor Ⅶa for Uncontrolled Perioperative BleedingZhi-gang Chang MD, PhD0Xin Chu MD1Wen Chen MD2Jun-hua Hu MD3Ji-wu Gong MD4Da-dong Liu MD5Qing He MD6Zhe Feng MD7Shi-rou Xiao MD8Ya-lin Liu MD9 Department of Surgical Intensive Care Medicine, , National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China Department of Surgical Intensive Care Medicine, , National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China School of Clinical Medicine, , Tianjin, People’s Republic of China Department of Transfusion, , National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China Department of Transfusion, , National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China Department of Critical Care Medicine, , Jiangsu, People’s Republic of China Department of Surgical Intensive Care Medicine, , National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China Department of Surgical Intensive Care Medicine, , National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China Department of Surgical Intensive Care Medicine, , National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China Department of Surgical Intensive Care Medicine, , National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of ChinaBackground: Recombinant activated factor VIIa (rFVIIa) is a prohemostatic agent initially approved for use in hemophilia patients and has also been used for a diverse range of off-label indications in the context of massive uncontrolled blood loss; however, no convincing evidence exists regarding the optimal dose of rFVIIa to treat uncontrolled bleeding in surgical patients. Aim: To evaluate the effects and safety of a very low dose of rFⅦa in patients with uncontrolled perioperative bleeding in the surgical intensive care unit (ICU). Methods: 55 patients from Beijing Hospital, who received rFⅦa between July 2004 and November 2018 for uncontrolled perioperative bleeding were included. The controls were matched for age, sex, severity, and operation type. The baseline demographics, survival, changes in bleeding and transfusion, coagulation parameters and complications were analyzed. Results: A low dose of rFⅦa (2.0∼3.6 mg, with a median dose of 39.02 μg/kg) appears to be effective in controlling massive hemorrhage (with an effective rate of 74.55%), and can reduce volume of red blood cell transfusion, improve coagulation status, while has a relatively low risk of thromboembolic complications (3.6%). Conclusion: In patients with uncontrolled perioperative bleeding, a low dose of rFⅦa could be used when traditional methods are ineffective.https://doi.org/10.1177/1559325820969569 |
| spellingShingle | Zhi-gang Chang MD, PhD Xin Chu MD Wen Chen MD Jun-hua Hu MD Ji-wu Gong MD Da-dong Liu MD Qing He MD Zhe Feng MD Shi-rou Xiao MD Ya-lin Liu MD Use of Low-Dose Recombinant Factor Ⅶa for Uncontrolled Perioperative Bleeding Dose-Response |
| title | Use of Low-Dose Recombinant Factor Ⅶa for Uncontrolled Perioperative Bleeding |
| title_full | Use of Low-Dose Recombinant Factor Ⅶa for Uncontrolled Perioperative Bleeding |
| title_fullStr | Use of Low-Dose Recombinant Factor Ⅶa for Uncontrolled Perioperative Bleeding |
| title_full_unstemmed | Use of Low-Dose Recombinant Factor Ⅶa for Uncontrolled Perioperative Bleeding |
| title_short | Use of Low-Dose Recombinant Factor Ⅶa for Uncontrolled Perioperative Bleeding |
| title_sort | use of low dose recombinant factor viia for uncontrolled perioperative bleeding |
| url | https://doi.org/10.1177/1559325820969569 |
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