Recombinant-activated factor VII as hemostatic therapy in eight cases of severe hemorrhage from esophageal varices
| Autor: | Francisco Pellicer-Bautista, Rafael Romero-Castro, Manuel Jimenez-Saenz, Juan Manuel Herrerías-Gutiérrez, Manuel Gomez-Parra, María Dolores Guerrero-Aznar, Federico Argüelles Arias, Angel Sendon-perez |
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| Rok vydání: | 2004 |
| Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Cirrhosis Balloon tamponade medicine.medical_treatment Factor VIIa Esophageal and Gastric Varices Severity of Illness Index Gastroenterology Endoscopy Gastrointestinal Hemostatics Catheterization chemistry.chemical_compound Esophageal varices Recurrence Internal medicine medicine Humans Prospective Studies Aged Aged 80 and over Prothrombin time Hepatology medicine.diagnostic_test Factor VII business.industry Standard treatment Balloon Occlusion Middle Aged medicine.disease Survival Analysis Recombinant Proteins Surgery Treatment Outcome chemistry Spain Hemostasis Prothrombin Time Portal hypertension Female Gastrointestinal Hemorrhage business |
| Zdroj: | Clinical Gastroenterology and Hepatology. 2:78-84 |
| ISSN: | 1542-3565 |
| DOI: | 10.1016/s1542-3565(03)00295-7 |
| Popis: | Background & Aims: There are several treatment options for gastroesophageal variceal hemorrhage. In severe cases, bleeding persists and is associated with a dismal outcome. The coagulation disorders might be correlated with risk of bleeding in patients with portal hypertension. The administration of activated recombinant factor VII corrects prothrombin time transiently in nonbleeding patients with cirrhosis as well as in bleeding ones. The aim of this study was to assess the hemostatic efficacy of activated recombinant factor VII in bleeding esophageal varices. Methods: Between May 2001 and September 2002, 112 patients with cirrhosis and an episode of acute esophageal variceal bleeding were admitted. On an open basis with a single intravenous dose of 4.8 mg of recombinant factor VII, we treated 8 patients experiencing severe and active hemorrhage from esophageal varices unresponsive to pharmacologic therapy, endoscopic therapy, or balloon tamponade. Results: Eight (7%) of 112 patients met entry criteria. Hemostasis was achieved in all the cases after recombinant activated factor VII therapy. Rebleeding and mortality rates were 25% and 50% (2 and 4 patients), respectively. Conclusions: In our experience, recombinant activated factor VII achieves hemostasis in bleeding esophageal varices unresponsive to standard treatment. |
| Databáze: | OpenAIRE |
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