Recombinant factor VIIa as last-resort treatment of desperate haemorrhage.
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field. Studies are inconclusive regarding clinical outcomes after administration of recombinant activated coagulation factor VII (rFVIIa) during severe haemorrhage. The circumstances encountered...
Published in: | Acta Anaesthesiologica Scandinavica |
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Online Access: | http://hdl.handle.net/2336/239052 https://doi.org/10.1111/j.1399-6576.2012.02688.x |
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ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/239052 2023-05-15T16:52:20+02:00 Recombinant factor VIIa as last-resort treatment of desperate haemorrhage. Palmason, R Vidarsson, B Sigvaldason, K Ingimarsson, J P Gudbjartsson, T Sigurdsson, G H Onundarson, P T Division of Internal Medicine, Landspitali-University Hospital, Reykjavik, Iceland. 2012-08-17 http://hdl.handle.net/2336/239052 https://doi.org/10.1111/j.1399-6576.2012.02688.x en eng Wiley-Blackwell http://dx.doi.org/10.1111/j.1399-6576.2012.02688.x Acta Anaesthesiol. Scand. 2012, 56(5):636-44 1399-6576 22489992 doi:10.1111/j.1399-6576.2012.02688.x http://hdl.handle.net/2336/239052 Acta anaesthesiologica Scandinavica Archived with thanks to Acta anaesthesiologica Scandinavica National Consortium - Landsaðgangur Adult Aged 80 and over Blood Transfusion Emergency Medical Services Extracorporeal Membrane Oxygenation Factor VIIa Female Hemorrhage Humans Iceland Injections Intravenous Male Middle Aged Partial Thromboplastin Time Prothrombin Time Recombinant Proteins Retrospective Studies Survival Analysis Treatment Outcome Young Adult Article Blóðlæknisfræði, Svæfing, Hjartaskurð. 2012 ftlandspitaliuni https://doi.org/10.1111/j.1399-6576.2012.02688.x 2022-05-29T08:21:49Z To access publisher full text version of this article. Please click on the hyperlink in Additional Links field. Studies are inconclusive regarding clinical outcomes after administration of recombinant activated coagulation factor VII (rFVIIa) during severe haemorrhage. The circumstances encountered during desperate haemorrhage make it difficult to include the most critically ill patients that could possibly benefit the most from such treatment into randomized controlled trials. We report our experience with rFVIIa as last-resort treatment of desperate haemorrhage when all standard treatment has failed. Hospital charts of all consecutive patients treated with rFVIIa for desperate non-haemophilic bleeding over a 10-year period at the single institution administering rFVIIa were surveyed for treatment indications, clinical outcome, transfusion need and coagulation profiles. Fifty-five rFVIIa treatment occasions of desperate bleeding were identified in 54 patients (median age 54 years). A single rFVIIa dose was used in 86%, and haemorrhage was considered effectively contained by immediate clinical response on 81% of occasions. Overall, 38 patients (71%) survived for over 30 days. Two thromboembolic events occurred (3.6%). The 24-h mortality in 45 rFVIIa immediate clinical responders and 10 non-responders was 2% and 50%, respectively (P = 0.0004), and the 30-day mortality was 25% and 60%, respectively (P = 0.05). Blood product use decreased with rFVIIa (P < 0.01) as did the prothrombin time (20.0-13.3 s, P < 0.0001). The majority of unselected consecutive patients receiving rFVIIa as last-resort treatment for desperate haemorrhage were considered to have immediate clinical response as well as reduced transfusion requirements and correction of coagulation parameters. An immediate clinical response to rFVIIa may possibly be predictive of survival. Landspitali University Hospital Scientific Foundation Article in Journal/Newspaper Iceland Hirsla - Landspítali University Hospital research archive Acta Anaesthesiologica Scandinavica 56 5 636 644 |
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Hirsla - Landspítali University Hospital research archive |
op_collection_id |
ftlandspitaliuni |
language |
English |
topic |
Adult Aged 80 and over Blood Transfusion Emergency Medical Services Extracorporeal Membrane Oxygenation Factor VIIa Female Hemorrhage Humans Iceland Injections Intravenous Male Middle Aged Partial Thromboplastin Time Prothrombin Time Recombinant Proteins Retrospective Studies Survival Analysis Treatment Outcome Young Adult |
spellingShingle |
Adult Aged 80 and over Blood Transfusion Emergency Medical Services Extracorporeal Membrane Oxygenation Factor VIIa Female Hemorrhage Humans Iceland Injections Intravenous Male Middle Aged Partial Thromboplastin Time Prothrombin Time Recombinant Proteins Retrospective Studies Survival Analysis Treatment Outcome Young Adult Palmason, R Vidarsson, B Sigvaldason, K Ingimarsson, J P Gudbjartsson, T Sigurdsson, G H Onundarson, P T Recombinant factor VIIa as last-resort treatment of desperate haemorrhage. |
topic_facet |
Adult Aged 80 and over Blood Transfusion Emergency Medical Services Extracorporeal Membrane Oxygenation Factor VIIa Female Hemorrhage Humans Iceland Injections Intravenous Male Middle Aged Partial Thromboplastin Time Prothrombin Time Recombinant Proteins Retrospective Studies Survival Analysis Treatment Outcome Young Adult |
description |
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field. Studies are inconclusive regarding clinical outcomes after administration of recombinant activated coagulation factor VII (rFVIIa) during severe haemorrhage. The circumstances encountered during desperate haemorrhage make it difficult to include the most critically ill patients that could possibly benefit the most from such treatment into randomized controlled trials. We report our experience with rFVIIa as last-resort treatment of desperate haemorrhage when all standard treatment has failed. Hospital charts of all consecutive patients treated with rFVIIa for desperate non-haemophilic bleeding over a 10-year period at the single institution administering rFVIIa were surveyed for treatment indications, clinical outcome, transfusion need and coagulation profiles. Fifty-five rFVIIa treatment occasions of desperate bleeding were identified in 54 patients (median age 54 years). A single rFVIIa dose was used in 86%, and haemorrhage was considered effectively contained by immediate clinical response on 81% of occasions. Overall, 38 patients (71%) survived for over 30 days. Two thromboembolic events occurred (3.6%). The 24-h mortality in 45 rFVIIa immediate clinical responders and 10 non-responders was 2% and 50%, respectively (P = 0.0004), and the 30-day mortality was 25% and 60%, respectively (P = 0.05). Blood product use decreased with rFVIIa (P < 0.01) as did the prothrombin time (20.0-13.3 s, P < 0.0001). The majority of unselected consecutive patients receiving rFVIIa as last-resort treatment for desperate haemorrhage were considered to have immediate clinical response as well as reduced transfusion requirements and correction of coagulation parameters. An immediate clinical response to rFVIIa may possibly be predictive of survival. Landspitali University Hospital Scientific Foundation |
author2 |
Division of Internal Medicine, Landspitali-University Hospital, Reykjavik, Iceland. |
format |
Article in Journal/Newspaper |
author |
Palmason, R Vidarsson, B Sigvaldason, K Ingimarsson, J P Gudbjartsson, T Sigurdsson, G H Onundarson, P T |
author_facet |
Palmason, R Vidarsson, B Sigvaldason, K Ingimarsson, J P Gudbjartsson, T Sigurdsson, G H Onundarson, P T |
author_sort |
Palmason, R |
title |
Recombinant factor VIIa as last-resort treatment of desperate haemorrhage. |
title_short |
Recombinant factor VIIa as last-resort treatment of desperate haemorrhage. |
title_full |
Recombinant factor VIIa as last-resort treatment of desperate haemorrhage. |
title_fullStr |
Recombinant factor VIIa as last-resort treatment of desperate haemorrhage. |
title_full_unstemmed |
Recombinant factor VIIa as last-resort treatment of desperate haemorrhage. |
title_sort |
recombinant factor viia as last-resort treatment of desperate haemorrhage. |
publisher |
Wiley-Blackwell |
publishDate |
2012 |
url |
http://hdl.handle.net/2336/239052 https://doi.org/10.1111/j.1399-6576.2012.02688.x |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
http://dx.doi.org/10.1111/j.1399-6576.2012.02688.x Acta Anaesthesiol. Scand. 2012, 56(5):636-44 1399-6576 22489992 doi:10.1111/j.1399-6576.2012.02688.x http://hdl.handle.net/2336/239052 Acta anaesthesiologica Scandinavica |
op_rights |
Archived with thanks to Acta anaesthesiologica Scandinavica National Consortium - Landsaðgangur |
op_doi |
https://doi.org/10.1111/j.1399-6576.2012.02688.x |
container_title |
Acta Anaesthesiologica Scandinavica |
container_volume |
56 |
container_issue |
5 |
container_start_page |
636 |
op_container_end_page |
644 |
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1766042495169331200 |