Recombinant activated factor VII (rFVIIa) in refractory haemorrhage for non-haemophiliacs: an eleven-year single-centre experience.

Autor: Shah NM; 1Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, PNG Malaysia., Chong SE; 1Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, PNG Malaysia.; 3Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, KTN Malaysia., Yusoff SM; 1Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, PNG Malaysia., Mazlan MZ; 2School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, KTN Malaysia.; 3Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, KTN Malaysia., Johan KB; 3Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, KTN Malaysia.; 5Department of Pharmacy, Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, KTN Malaysia., Azman N; 1Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, PNG Malaysia., Lim JA; 4Department of Internal Medicine, Hospital Sultan Abdul Halim, 08000 Sungai Petani, KDH Malaysia., Mohamad SM; 1Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, PNG Malaysia., Noordin SS; 1Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, PNG Malaysia., Ghaffar ZA; 6Integrative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, PNG Malaysia., Hassan MH; 2School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, KTN Malaysia.; 3Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, KTN Malaysia., Zabidi MA; 1Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, PNG Malaysia., Rahim NAA; 1Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, PNG Malaysia.
Jazyk: angličtina
Zdroj: BMC hematology [BMC Hematol] 2018 Nov 23; Vol. 18, pp. 34. Date of Electronic Publication: 2018 Nov 23 (Print Publication: 2018).
DOI: 10.1186/s12878-018-0126-z
Abstrakt: Background: Massive bleeding is one of the commonest salvageable causes of death. The search for an ideal haemostatic agent during massive bleeding is still ongoing. One of the novel haemostatic medications is recombinant activated factor VII (rFVIIa). To date, the usage of rFVIIa during massive haemorrhage among non-haemophiliac patients remains off-label. The aim of this study is to report our experience in using rFVIIa to treat refractory bleeding.
Methods: Medical records of all patients treated with rFVIIa for massive bleeding over an eleven-year period in a single institution were recorded. Treatment indications, 24-h and 30-day mortality, changes in transfusion needs and coagulation profiles after rFVIIa administration were analysed.
Results: rFVIIa were administered in 76 patients. Of these, 41 (53.9%) were non-surgical bleeding, followed by 22 patients (28.9%) with trauma, other surgery bleedings in 9 patients (11.8%) and 4 patients (5.4%) with peripartum haemorrhage. Total survival rate was 78.9% within 24 h and 44.7% over 30 days. Among all these patients who had received rFVIIa due to life-threatening haemorrhage, blood and blood product requirements were significantly reduced ( P  < 0.001), and the coagulation profiles improved significantly ( P  < 0.05). Two patients with preexisting thromboembolism were given rFVIIa due to intractable bleeding, both survived. No thromboembolic events were reported after the administration of rFVIIa.
Conclusions: rFVIIa significantly improved coagulation parameters and reduced blood product requirements during refractory haemorrhage. Additionally, usage of rFVIIa in trauma and peripartum haemorrhage patients yield better outcomes than other groups of patients. However, the overall mortality rate remained high.
Competing Interests: The authors declare that they have no competing interests.For this retrospective non-interventional study, the need for informed consent for data collection has been waived and was approved by the institutional review board, the Human Ethics Committee of Universiti Sains Malaysia (Reference number: USM/JEPeM/16120535). Patient privacy and confidentiality was protected with data anonymization in the data collection forms. Unauthorised person had no access to the collected data from medical record and chart review.Not applicable.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Databáze: MEDLINE
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