Document Detail


Small-dose recombinant activated factor VII (NovoSeven) in cardiac surgery.
MedLine Citation:
PMID:  16632803     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Stefano Romagnoli; Sergio Bevilacqua; Sandro Gelsomino; Silvia Pradella; Lorenzo Ghilli; Carlo Rostagno; Gian Franco Gensini; Carlo Sorbara
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  102     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-04-24     Completed Date:  2006-05-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1320-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiac Surgery; Careggi Hospital, Florence, Italy. romagnoliste@tiscali.it
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MeSH Terms
Descriptor/Qualifier:
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:
EC 3.4.21.21/Factor VIIa

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


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