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Antidotes to haemorrhage: recombinant factor VIIa.

This is an excellent and comprehensive review on the use of rFVIIa, its mechanism of action and various indications for its use in controlling bleeding in congenital and acquired coagulation disorders: factors VIII or IX deficiencies, oral vitamin K antagonists overdose, direct and indirect thrombin inhibitors, platelet disorders, and bleeding due to surgery or trauma. […]

The effects of a polymerized bovine-derived hemoglobin solution in a rabbit model of arterial thrombosis and bleeding.

Using a well recognized experimental model, the authors demonstrated that polymerized bovine-based hemoglobin solution markedly reduced arterial thrombosis rate and increased bleeding time in rabbits. These results are in contrast with those reported with other hemoglobin-based oxygen carriers. There is increasing evidence that the effects of hemoglobin solutions on hemostasis can be influenced by their […]

Increased local procoagulant action: a mechanism contributing to the favorable hemostatic effect of recombinant FVIIa in PLT disorders.

This paper reports the procoagulant effect of rFVIIa in experimental thrombocytopenia, and in thromboasthenic platelets due to natural or experimentally induced glycoprotein deficiency. It shows that rFVIIa improved fibrin deposition, thrombin generation and platelet interaction at sites of vascular damage. These observations may explain the hemostatic effects of rFVIIa in controlling hemorrhage in patients with […]

The use of recombinant factor VIIa in children with inherited platelet function disorders.

This is an interesting report on a small series of children with inherited platelet dysfunction treated with rFVIIa for acute bleeding or preoperatively. Response seemed to correlate with type of underlying condition, severity of bleeding and delay in presentation. In this series rFVIIa had variable efficacy in securing hemostasis. There was no difference in requirement […]

Effect of recombinant activated factor VII on perioperative blood loss in patients undergoing retropubic prostatectomy: a double-blind placebo-controlled randomised trial.

This is an interesting and important controlled study on using rFVIIa electively in the beginning of major surgery to reduce blood loss and blood transfusion. Patients were divided into three groups who received either placebo or rFVIIa at two doses: 20 μg/kg or 40 μg/kg. There was significant reduction in blood loss in the rFVIIa […]

Treatment of critical bleeding in the future intensive care unit. [Editorial]

Uncontrolled bleeding remains a major problem in intensive care and emergency medicine which still requires effective and innovative treatment options. This editorial highlights that there is growing evidence on the efficacy of rFVIIa (Novoseven) in controlling such bleeding, and that clinical trials in different patient populations are required to assess its efficacy and safety. – […]