• Birgit Wittenstein, Cho Ng, Hanne Ravn, and Allan Goldman.
• Great Ormond Street Hospital for Children, London, UK.
• Pediatr Crit Care Me. 2005 Jul 1;6(4):473-6.

ObjectivesSevere bleeding is a recognized complication during mechanical cardiopulmonary support with extracorporeal membrane oxygenation. We present the use of recombinant activated factor VII (rFVIIa) for severe, refractory bleeding during extracorporeal membrane oxygenation support after open-heart surgery for congenital heart disease.DesignRetrospective review of all patients receiving rFVIIa on extracorporeal membrane oxygenation.SettingA pediatric extracorporeal membrane oxygenation center located within the cardiac intensive care unit of a tertiary care children's hospital.PatientsFour patients treated with rFVIIa for refractory bleeding on extracorporeal membrane oxygenation.InterventionsThe patients received rFVIIa for severe, refractory blood loss despite applying clotting products and aprotinin infusion and excluding surgical reasons.Measurements And Main ResultsrFVIIa was given 4-7 hrs after commencing extracorporeal membrane oxygenation; a second identical dose was administered 4 hrs later. Bleeding decreased significantly in all patients within 30 mins after the first dose of rFVIIa; no side effects were observed.ConclusionsrFVIIa is effective to achieve control of refractory hemorrhage in patients on extracorporeal membrane oxygenation. Now a randomized controlled trial to evaluate risks and benefits of rFVIIa on patients undergoing extracorporeal membrane oxygenation is required.

17 keywords...

hide…