Use of recombinant factor VIIa for emergency reversal of anticoagulation.
J Postgrad Med
;
2007 Jan-Mar; 53(1): 17-22
Article
in English
| IMSEAR
| ID: sea-117334
ABSTRACT
CONTEXT There is limited data regarding the use of activated recombinant factor VII (rFVIIa) in anticoagulated patients requiring reversal. Aims:
To identify and describe characteristics of subjects who received rFVIIa as part of emergency treatment aimed at improving hemostasis. SETTINGS ANDDESIGN:
Data was obtained from an international peer-reviewed registry haemostasis.com. This registry contains data reported by physicians, who had elected to use rFVIIa to control bleeding in an emergency clinical situation. The contributors' approval for inclusion in the study was obtained and they were requested to validate and update information. MATERIALS ANDMETHODS:
Database review of cases receiving rFVIIa to manage bleeding coherent with the use of anticoagulant therapy. StatisticalAnalysis:
The Wilcoxon signed rank test was used to compare requirements for blood products and crystalloids/colloids during the 24h preceding and following rFVIIa administration, as well as changes in the levels of clotting factors during that period.RESULTS:
Eighteen patients were treated with rFVIIa (median dose 87.35 microg/kg; range 20.0-106.0 microg/kg) for bleeding. Anticoagulants requiring reversal included low-molecular-weight heparin (n = 6), unfractionated heparin (n =8), coumarin (n =3) and warfarin (n=1). All patients had failed to respond to traditional antidotes and blood products. Following administration, bleeding stopped in 10, markedly decreased in five and slowed in the remaining three. Amongst 12/16 patients, a response was observed within 2.0 h of first administration. The requirement for blood products and crystalloids/colloids decreased ( P < 0.05) after rFVIIa administration. rFVIIa was well tolerated.CONCLUSIONS:
rFVIIa may play a role in control of untoward bleeding in subjects receiving anticoagulation therapy.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Blood Coagulation
/
Recombinant Proteins
/
Aged
/
Female
/
Humans
/
Male
/
Factor VII
/
Coagulants
/
Factor VIIa
/
Registries
Type of study:
Prognostic study
Language:
English
Journal:
J Postgrad Med
Year:
2007
Type:
Article
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