Árangur á notkun líftæknigerðs espaðs storkuþáttar VIIa við meiriháttar blæðingum í opnum hjartaskurðaðgerðum
Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/Open INTRODUCTION: We evaluated the efficacy of activated recombinant factor VIIa (rFVIIa) administration for critical bleeding during cardiothoracic surgery in Iceland. MATERIALS AND METHODS: Over a 33 month...
Main Authors: | , , , , |
---|---|
Format: | Article in Journal/Newspaper |
Language: | Icelandic |
Published: |
Læknafélag Íslands, Læknafélag Reykjavíkur
2008
|
Subjects: | |
Online Access: | http://hdl.handle.net/2336/41986 |
id |
ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/41986 |
---|---|
record_format |
openpolar |
spelling |
ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/41986 2023-05-15T16:49:39+02:00 Árangur á notkun líftæknigerðs espaðs storkuþáttar VIIa við meiriháttar blæðingum í opnum hjartaskurðaðgerðum The use of recombinant activated factor VIIa for major bleedings in open heart surgery Jóhann Páll Ingimarsson Páll T. Önundarson Felix Valsson Brynjar Viðarsson Tómas Guðbjartsson 2008-12-08 http://hdl.handle.net/2336/41986 ice is ice Læknafélag Íslands, Læknafélag Reykjavíkur http://www.laeknabladid.is Læknablaðið 2008, 94(9):607-12 0023-7213 18784387 http://hdl.handle.net/2336/41986 Læknablaðið Hjartasjúkdómar Hjartaaðgerðir Blæðingar (áverkar) Adult Anticoagulants Blood Loss Surgical Cardiac Surgical Procedures Erythrocyte Transfusion Factor VIIa Hemostatic Techniques Iceland Postoperative Hemorrhage Recombinant Proteins Reoperation Retrospective Studies Treatment Outcome Article 2008 ftlandspitaliuni 2022-05-29T08:21:13Z Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/Open INTRODUCTION: We evaluated the efficacy of activated recombinant factor VIIa (rFVIIa) administration for critical bleeding during cardiothoracic surgery in Iceland. MATERIALS AND METHODS: Over a 33 month period, 10 consecutive patients with major life-threatening bleeding during or right after open cardiac surgery that received rFVIIa in 11 operations. Clinical information was retrospectively collected from hospital charts. RESULTS: The 10 patients were on average 66 year old, ranging 36-82 yrs. All patients were NYHA-class III or IV, there of three underwent emergency surgery. Complicated AVR+/-CABG was the most common type of operation (n=5), with average operation time 673 min. (range 475-932) and perfusion time 287 min. (range 198-615). After the administration of rFVIIa, haemostasis was acquired in 8 of 11 operations, with a significant improvement in coagulation parameters. Three patiens needed reoperation for bleeding. Transfusion of packed red cell (p=0.002) and plasma (p<0.02) decreased significantly after administration of rFVIIa and prothrombin time was shortened (p<0.004). Five patients succumbed, one of them with a cerebral infarction and pulmonary embolus, the latter confirmed at autopsy. Other causes of death were intractable bleeding, myocardial infarction, multiorgan failure and disseminated intravascular coagulopathy. CONCLUSIONS: rFVIIa can be used effectively to stop intractable bleedings in open heart surgery, with 8 out of 11 patients in this small series achieving hemostasis after its administration. Mortality in this group of patients was high (50%), however, in all cases rFVIIa was used as an end-of-the-line treatment where other therapy had failed. One patient died from pulmonary embolism and cerebral infarct, raising the question of hypercoagulation. Further studies on the side effects and indications of rFVIIa treatment are necessary. Inngangur: Rannsakaður var með aftursæjum ... Article in Journal/Newspaper Iceland Hirsla - Landspítali University Hospital research archive Smella ENVELOPE(29.443,29.443,69.896,69.896) |
institution |
Open Polar |
collection |
Hirsla - Landspítali University Hospital research archive |
op_collection_id |
ftlandspitaliuni |
language |
Icelandic |
topic |
Hjartasjúkdómar Hjartaaðgerðir Blæðingar (áverkar) Adult Anticoagulants Blood Loss Surgical Cardiac Surgical Procedures Erythrocyte Transfusion Factor VIIa Hemostatic Techniques Iceland Postoperative Hemorrhage Recombinant Proteins Reoperation Retrospective Studies Treatment Outcome |
spellingShingle |
Hjartasjúkdómar Hjartaaðgerðir Blæðingar (áverkar) Adult Anticoagulants Blood Loss Surgical Cardiac Surgical Procedures Erythrocyte Transfusion Factor VIIa Hemostatic Techniques Iceland Postoperative Hemorrhage Recombinant Proteins Reoperation Retrospective Studies Treatment Outcome Jóhann Páll Ingimarsson Páll T. Önundarson Felix Valsson Brynjar Viðarsson Tómas Guðbjartsson Árangur á notkun líftæknigerðs espaðs storkuþáttar VIIa við meiriháttar blæðingum í opnum hjartaskurðaðgerðum |
topic_facet |
Hjartasjúkdómar Hjartaaðgerðir Blæðingar (áverkar) Adult Anticoagulants Blood Loss Surgical Cardiac Surgical Procedures Erythrocyte Transfusion Factor VIIa Hemostatic Techniques Iceland Postoperative Hemorrhage Recombinant Proteins Reoperation Retrospective Studies Treatment Outcome |
description |
Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/Open INTRODUCTION: We evaluated the efficacy of activated recombinant factor VIIa (rFVIIa) administration for critical bleeding during cardiothoracic surgery in Iceland. MATERIALS AND METHODS: Over a 33 month period, 10 consecutive patients with major life-threatening bleeding during or right after open cardiac surgery that received rFVIIa in 11 operations. Clinical information was retrospectively collected from hospital charts. RESULTS: The 10 patients were on average 66 year old, ranging 36-82 yrs. All patients were NYHA-class III or IV, there of three underwent emergency surgery. Complicated AVR+/-CABG was the most common type of operation (n=5), with average operation time 673 min. (range 475-932) and perfusion time 287 min. (range 198-615). After the administration of rFVIIa, haemostasis was acquired in 8 of 11 operations, with a significant improvement in coagulation parameters. Three patiens needed reoperation for bleeding. Transfusion of packed red cell (p=0.002) and plasma (p<0.02) decreased significantly after administration of rFVIIa and prothrombin time was shortened (p<0.004). Five patients succumbed, one of them with a cerebral infarction and pulmonary embolus, the latter confirmed at autopsy. Other causes of death were intractable bleeding, myocardial infarction, multiorgan failure and disseminated intravascular coagulopathy. CONCLUSIONS: rFVIIa can be used effectively to stop intractable bleedings in open heart surgery, with 8 out of 11 patients in this small series achieving hemostasis after its administration. Mortality in this group of patients was high (50%), however, in all cases rFVIIa was used as an end-of-the-line treatment where other therapy had failed. One patient died from pulmonary embolism and cerebral infarct, raising the question of hypercoagulation. Further studies on the side effects and indications of rFVIIa treatment are necessary. Inngangur: Rannsakaður var með aftursæjum ... |
format |
Article in Journal/Newspaper |
author |
Jóhann Páll Ingimarsson Páll T. Önundarson Felix Valsson Brynjar Viðarsson Tómas Guðbjartsson |
author_facet |
Jóhann Páll Ingimarsson Páll T. Önundarson Felix Valsson Brynjar Viðarsson Tómas Guðbjartsson |
author_sort |
Jóhann Páll Ingimarsson |
title |
Árangur á notkun líftæknigerðs espaðs storkuþáttar VIIa við meiriháttar blæðingum í opnum hjartaskurðaðgerðum |
title_short |
Árangur á notkun líftæknigerðs espaðs storkuþáttar VIIa við meiriháttar blæðingum í opnum hjartaskurðaðgerðum |
title_full |
Árangur á notkun líftæknigerðs espaðs storkuþáttar VIIa við meiriháttar blæðingum í opnum hjartaskurðaðgerðum |
title_fullStr |
Árangur á notkun líftæknigerðs espaðs storkuþáttar VIIa við meiriháttar blæðingum í opnum hjartaskurðaðgerðum |
title_full_unstemmed |
Árangur á notkun líftæknigerðs espaðs storkuþáttar VIIa við meiriháttar blæðingum í opnum hjartaskurðaðgerðum |
title_sort |
árangur á notkun líftæknigerðs espaðs storkuþáttar viia við meiriháttar blæðingum í opnum hjartaskurðaðgerðum |
publisher |
Læknafélag Íslands, Læknafélag Reykjavíkur |
publishDate |
2008 |
url |
http://hdl.handle.net/2336/41986 |
long_lat |
ENVELOPE(29.443,29.443,69.896,69.896) |
geographic |
Smella |
geographic_facet |
Smella |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
http://www.laeknabladid.is Læknablaðið 2008, 94(9):607-12 0023-7213 18784387 http://hdl.handle.net/2336/41986 Læknablaðið |
_version_ |
1766039797284995072 |