| Recombinant factor VIIa reduces bleeding after blunt liver injury in coagulopathic, hypofibrinogenaemic pigs. | |
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MedLine Citation:
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PMID: 20926476 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Recombinant factor VIIa (rFVIIa) has been successfully used in various clinical conditions to treat severe coagulopathy, but its efficacy may be affected by the underlying conditions. We therefore investigated the efficacy of rFVIIa treatment under conditions of hypofibrinogenaemia in a pig model of blunt liver injury. METHODS: Severe haemodilution was instigated in four groups of seven anaesthetized pigs. Before inflicting liver injury, animals were assigned to receive either 70 mg kg(-1) fibrinogen (fibrinogen group) or placebo (control group). Thirty seconds after injury, rFVIIa (180 µg kg(-1)) (rFVIIa and fibrinogen+rFVIIa groups) or vehicle (control and fibrinogen groups) was administered. Haemodynamic variables, coagulation parameters, and blood loss were monitored for 2 h. Histology was examined to evaluate the presence of thrombi and the consistency of liver injury. RESULTS: At the end of the observation period, total blood loss [median (range)] decreased in all intervention groups [fibrinogen: 1275 (1221-1439) ml, P=0.036; rFVIIa: 966 (923-1136) ml, P=0.008; fibrinogen+rFVIIa: 678 (475-756) ml, P=0.008] when compared with control animals [blood loss: 1752 (1735-2221) ml]. The mortality rate in the control group was 100%, whereas only 42% of fibrinogen-substituted animals died (P=0.023). All animals treated with rFVIIa or fibrinogen+rFVIIa (P<0.001) survived and no signs of thromboembolism were observed. CONCLUSIONS: rFVIIa under conditions of hypofibrinogenaemia exhibited a positive impact on coagulation parameters and a reduction in blood loss. These effects were significantly improved after prior substitution with fibrinogen. |
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Authors:
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O Grottke; T Braunschweig; L Zimmermann; R Kopp; B Lauritzen; M Coburn; R Tolba; R Rossaint |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-10-06 |
Journal Detail:
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Title: British journal of anaesthesia Volume: 105 ISSN: 1471-6771 ISO Abbreviation: Br J Anaesth Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-18 Completed Date: 2010-12-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372541 Medline TA: Br J Anaesth Country: England |
Other Details:
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Languages: eng Pagination: 789-97 Citation Subset: IM |
Affiliation:
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Department of Anaesthesiology, RWTH Aachen University Hospital, Pauwelsstrasse 30, D-52074 Aachen, Germany. ogrottke@ukaachen.de |
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Blood Coagulation Disorders / complications, drug therapy Disease Models, Animal Drug Evaluation, Preclinical Factor VIIa / therapeutic use* Fibrin / deficiency* Fibrinogen / metabolism Hemodilution Hemodynamics Hemorrhage / blood, drug therapy*, etiology Hemostatics / therapeutic use Liver / injuries* Male Pilot Projects Prothrombin Time Recombinant Proteins / therapeutic use Sus scrofa Thrombelastography / methods Wounds, Nonpenetrating / complications* |
| Chemical | |
Reg. No./Substance:
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0/Hemostatics; 0/Recombinant Proteins; 0/recombinant FVIIa; 9001-31-4/Fibrin; 9001-32-5/Fibrinogen; EC 3.4.21.21/Factor VIIa |
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