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 […]
This is a clearly written article detailing the mechanism of action of rFVIIa and its interaction with tissue factor and platelets leading to its hemostatic effect in hemophilia patients with inhibitors and those with platelet disorders. – Maadh Aldouri
Activated recombinant factor VII for control of diffuse bleeding after implantation of ventricular assist device.
This is another case report on the use of rFVIIa in controlling excessive bleeding during open heart surgery. A 57 year old woman underwent implantation of bilateral ventricular assist device for management of cardiogenic shock. The procedure was complicated by excessive bleeding which did not respond to massive transfusion of blood products, in addition to […]
Synthetic factor VIIa concentrate to treat coagulopathy and gastrointestinal bleeding in an infant with end-stage liver disease.
This is a case report on a successful use of recombinant factor VIIa in treating hematemesis in an 11-month-old infant who suffered with esophageal varices, hepatic dysfunction and previous necrotizing enterocolitis. Prior treatment with platelets, FFP and octreotide did not succeed in controlling the bleeding. – Maadh Aldouri
This study illustrates one of the unusual situations in Medicine where evidence of drug efficacy in human preceded animal studies. After the publication of several case reports on the effectiveness of rFVIIa in controlling traumatic bleeding, this study proves its efficacy in reducing bleeding after grade V liver injury in hypothermic dilutionally coagulopathic pigs, as […]
This is another case report on the efficacy of Novoseven in controlling severe bleeding in cardiac surgery. Post-operative bleeding continued in spite of the use of blood products and aprotinin infusion, but stopped after a single dose of rFVIIa. Coronary catheterization performed after giving rFVIIa showed good aortic prosthetic function and no alteration in the […]
Nice overview, but inconsistency between recommendations in the figures and in the text. – V. Kretschmer
Application of recombinant activated factor VII during surgery for a giant skull base hemangiopericytoma to achieve safe hemostasis. Case report.
This is an interesting case report on the use of rFVIIa in treating uncontrollable surgical bleeding in a patient not known to have a pre-existing coagulopathy. The patient had a recurrent hemangiopericytoma and bleeding did not respond to transfusing a large number of blood products. He eventually responded to two doses of rFVIIa (120 μg/kg) […]
Epinephrine versus epinephrine plus fibrin glue injection in peptic ulcer bleeding: a prospective randomized trial.
A useful study (notwithstanding power) and review of current practices. – F. Regan and M. Contreras.
This survey reflects the current situation in England and North Wales, where the prevailing opinion is that only the use of blood components is state of the art. There is decreasing need of source plasma for the industrial production of plasma derivatives due to recombinant products. England cannot use the plasma due to fear of […]
This article starts with a general overview on mechanism of action, uses and safety of rFVIIa as well as the hemostatic disorders which are associated with liver disease. It states the correlation between the degree of liver damage and level and gene expression of FVII. The authors reviewed the use of rFVIIa in liver disease […]
This is a relatively new area for using rFVIIa, which is to treat uncontrolled haemorrhage in patients with severe trauma, following the earlier report of using rFVIIa successfully in treating bleeding in a soldier who suffered with bullet injur (Kenet et al., Lancet 1999;354:1879). rFVIIa was effective in controlling bleeding and resulted in significant reduction […]
Recombinant activated factor VII (RFVIIa) acutely normalizes prothrombin time in patients with cirrhosis during bleeding from oesophageal varices.
This is a new open-label study, which showed efficacy of rFVIIa in normalising prothrombin time and effective control of bleeding esophageal varices in cirrhotic patients, in addition to safety in using rFVIIa. – M. Aldouri.
Development of an animal model for assessment of the hemostatic efficacy of fibrin sealant in vascular surgery.
Having a sound and reproducible animal model to test the value of an existing therapy beyond its initial application is certainly a step forward. Kheirabadi and associates have taken this step for us in a vascular surgery model for fibrin sealant use. Their results are consistent with what we have learned anecdotally in clinical practice […]
This inovative work bears watching. Potential applications include minimally invasive, i.e., laparoscopic, approaches to control of traumatic liver injury. – R. K. Spence.