Document Detail


Recombinant activated factor VII use in critically ill infants with active hemorrhage.
MedLine Citation:
PMID:  19040942     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Recombinant activated factor VII (rFVIIa) is infrequently used off-label in infants despite a paucity of data in this population. We report a retrospective review of rFVIIa use in infants focusing on safety and efficacy. METHOD: Between 2002 and 2007, 32 critically ill nonhemophiliac infants less than 1 year old received rFVIIa at our institution. Indications of rFVIIa and post-rFVIIa venous thrombosis were reviewed. Transfusion requirements were calculated 8 hours before and after rFVIIa administration. RESULTS: Infants received on average 2 doses of rFVIIa at a mean dosage of 90 microg/kg. Active hemorrhage was the indication for rFVIIa in 24 infants, which included postoperative bleeding in 16 and nonsurgical bleeding in 8. The remaining 8 infants had preoperative coagulopathy. Thrombosis was noted in 4 infants (13%) and was not related to transfusion requirements, the number of doses, or dosage of rFVIIa. For infants who had active hemorrhage, rFVIIa was able to significantly reduce the requirements of packed red blood cells by 36.17 mL/kg (P < .005), platelets by 10.31 mL/kg (P < .01), and cryoprecipitates by 2.19 mL/kg (P < .05). CONCLUSION: This is the first large case series demonstrating the efficacy of rFVIIa in critically ill infants with active hemorrhage by reducing their transfusion requirements. Furthermore, venous thrombosis was not associated with increase in either the number of doses or dosage of rFVIIa.
Authors:
Howard Jen; Stephen Shew
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  43     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-01     Completed Date:  2009-03-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2235-8     Citation Subset:  IM    
Affiliation:
Division of Pediatric Surgery, UCLA School of Medicine-Mattel Children's Hospital, Los Angeles, CA 90095-7098, USA.
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MeSH Terms
Descriptor/Qualifier:
Blood Component Transfusion / economics,  utilization
Critical Care / economics,  statistics & numerical data*
Critical Illness
Factor VIII / economics,  therapeutic use
Factor VIIa / adverse effects,  economics,  therapeutic use*
Female
Fibrinogen / economics,  therapeutic use
Hemorrhage / drug therapy*
Hemostatics / adverse effects,  economics,  therapeutic use*
Humans
Infant
Male
Postoperative Hemorrhage / drug therapy
Recombinant Proteins / adverse effects,  economics,  therapeutic use
Retrospective Studies
Venous Thrombosis / chemically induced
Chemical
Reg. No./Substance:
0/Hemostatics; 0/Recombinant Proteins; 0/cryoprecipitate coagulum; 0/recombinant FVIIa; 9001-27-8/Factor VIII; 9001-32-5/Fibrinogen; EC 3.4.21.21/Factor VIIa

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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