Small-dose recombinant activated factor VII (NovoSeven) in cardiac surgery
| Autor: | Stefano Romagnoli, Sandro Gelsomino, Silvia Pradella, Lorenzo Ghilli, Sergio Bevilacqua, Carlo Sorbara, Carlo Rostagno, Gian Franco Gensini |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Factor VIIa Postoperative Hemorrhage Statistics Nonparametric law.invention law Activated factor VII medicine Humans Platelet Cardiac Surgical Procedures Aged Prothrombin time Aged 80 and over Chi-Square Distribution medicine.diagnostic_test business.industry Middle Aged Intensive care unit Cardiac surgery Anesthesiology and Pain Medicine Anesthesia Recombinant DNA Prothrombin Time Female Bolus (digestion) business Chi-squared distribution |
| Zdroj: | Anesthesia and analgesia. 102(5) |
| ISSN: | 1526-7598 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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