| Small-dose recombinant activated factor VII (NovoSeven) in cardiac surgery. | |
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MedLine Citation:
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PMID: 16632803 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Recombinant activated factor VII (rFVIIa) has been used at different doses in cardiac surgery patients. We tested the efficacy of small-dose rFVIIa in patients with intractable bleeding after cardiac surgery. The study group comprised 15 cardiac surgery patients with intractable bleeding treated with small-dose (1.2 mg) rFVIIa as a slow IV bolus at the end of complete step-by step transfusion protocol. Fifteen matched patients undergoing the same transfusion protocol in the pre-rFVIIa era represented the control group. Blood loss at the end of the transfusion protocol was a primary outcome. Median, 25th-75th 24-h blood loss percentiles were 1685 (1590-1770) mL versus 3170 (2700-3850) mL in study group and controls, respectively (P = 0.0004). Transfused red blood cells, fresh-frozen plasma, and platelets in the study group and controls were as follows: 7 (4-8) U versus 18 (12-21) U (P = 0.001); 7.5 (6-11) U versus 11 (9-15) U (P = 0.003); 0 (0-4) U versus 9 (6-13) U (P = 0.001). In addition, significant improvements of prothrombin time (P = 0.015), international normalized ratio (P = 0.006), activated partial prothrombin time (P = 0.01), and platelet count (P = 0.003) were detected in the study group versus controls. Finally, patients receiving rFVIIa showed a reduced intensive care unit length of stay (chi2 = 15.9, P = 0.0001) and had infrequent surgical re-exploration (chi2 = 16.2,P < 0.0001). Small-dose rFVIIa showed satisfactory results in cardiac patients with intractable bleeding. Further randomized studies are necessary to confirm our findings. |
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Authors:
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Stefano Romagnoli; Sergio Bevilacqua; Sandro Gelsomino; Silvia Pradella; Lorenzo Ghilli; Carlo Rostagno; Gian Franco Gensini; Carlo Sorbara |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 102 ISSN: 1526-7598 ISO Abbreviation: Anesth. Analg. Publication Date: 2006 May |
Date Detail:
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Created Date: 2006-04-24 Completed Date: 2006-05-17 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
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Languages: eng Pagination: 1320-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiac Surgery; Careggi Hospital, Florence, Italy. romagnoliste@tiscali.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Cardiac Surgical Procedures / adverse effects* Chi-Square Distribution Factor VIIa / administration & dosage* Female Humans Male Middle Aged Postoperative Hemorrhage / drug therapy* Prothrombin Time / statistics & numerical data Statistics, Nonparametric |
| Chemical | |
Reg. No./Substance:
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EC 3.4.21.21/Factor VIIa |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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