Managing uncontrolled hemorrhage in trauma and surgery: a novel and promising approach.

This is an introduction for a supplement to the Canadian Journal of Anesthesia reporting proceedings of a satellite symposium presented at the 2002 Canadian Anesthesiologists’ Society Annual Meeting. It highlights the role of rFVIIa in managing bleeding in hemophilia patients with inhibitors, and the increasing number of case reports and studies in its role in […]

The effect of recombinant factor VIIa on coagulopathic pigs with grade V liver injuries.

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 […]

Efficacy of recombinant factor VIIa administered by continuous infusion to haemophilia patients with inhibitors.

This is an interesting study looking at the efficacy of administering rFVIIa in controlling bleeding in 43 episodes in 14 hemophilia patients with inhibitors. RFVIIa infusion was not effective in controlling oral bleeding, but effective in controlling bleeding in other sites. The authors postulate that rFVIIa infusion was not effective in activating thrombin activatable fibrinolysis […]

Orthopaedic surgery in haemophilic patients with inhibitors: an overview.

This is an excellent review on a large series reporting the use of rFVIIa in orthopedic surgeries in patients with hemophilia A and B with inhibitors, in addition to a review of the literature. Major orthopedic procedures were carried out, as well as multiple proce-dures on the same patients were possible with very good efficacy […]

Continuous infusion of coagulation factor products.

This is an interesting review on the use of continuous infusion of coagulation factor products over the last 11 years. It concludes that effects were favorable in comparison to intermittent bolus infusions. It suggests that continuous infusion has the advantage of maintaining a therapeutic level of the factor, and is associated with decrease in factor […]

Early use of recombinant factor VIIa improves mean arterial pressure and may potentially decrease mortality in experimental hemorrhagic shock: A pilot study.

This is an interesting work showing the efficacy of rFVIIa in controlling post traumatic hemorrhage in an animal model, especially after the publication of several case reports of the effective treatment of excessive bleeding following surgery or trauma in non-hemophiliac patients with rFVIIa. After avulsion of left median lobe of the liver, swines were randomized […]

Effective hemostasis with rFVIIa treatment in two patients with severe thrombocytopenia and life-threatening hemorrhage.

This article reports 2 patients with severe thrombocytopenia and severe hemorrhage which did not respond to standard therapy and platelet transfusion, but responded quickly to administration of a single dose of rFVIIa. The first patient had Waldenstoms macroglobulinemia and immune thrombocytopenia, and the second one had acute lymphoblastic leukemia. No adverse effects for rFVIIa were […]

Massive pseudotumour resection with recombinant factor VIIa (NovoSeven) cover.

This is an interesting case report on the use of rFVIIa in covering surgical resection of a large right gluteal pseudo-tumor in a 32-year-old patient with severe hemophilia A and high-titer inhibitor. Factor VIIa was administered for 72 hours and monitored with measurement of PT and factor VII coagulation activity, and the latter was found […]