• Rev Esp Anestesiol Reanim · Oct 2009

    [Efficacy of recombinant activated factor VII for massive bleeding after cardiac surgery: experience with 32 patients].

    • C Millán, B Quintana, A Rodríguez, M Iglesias, M Barranco, and J Navia.
    • Departamento de Anestesiología y Reanimación, Hospital General Universitario "Gregorio Marañńon", Madrid. carmia@mailpersonal.com
    • Rev Esp Anestesiol Reanim. 2009 Oct 1;56(8):485-92.

    ObjectiveTo determine the efficacy of recombinant activated factor VII (rFVIIa) to treat massive bleeding refractory to conventional treatment following cardiac surgery.Patients And MethodsRetrospective study of 32 adults who underwent cardiac surgery and received rFVIIa to treat life-threatening postoperative bleeding after conventional means of correcting coagulopathy had failed.ResultsAfter administration of rFVIIa (90 microg x kg(-1), coagulation parameters soon became normal and blood loss decreased, with drainage going from a mean (SD) of 463 (321) mL in the hour when rFVIIa was infused to 155 (101) mL in the next hour (P < .001). Blood loss decreased by between 22% and 90% (mean, 66%), and the reduction was over 75% in 45% of the patients. Decreases in the transfusion of packed red blood cells (from 7A.4 [4.1] units to 2.7 [ 2.9] units; P < .001), plasma (from 4.7 [2.9] units to 1.6 [2.0] units; P < .001), and platelets were also noted. Mortality was 25%, although only 1 patient died from hemorrhagic shock. One patient developed thromboembolic complications (ischemic stroke).ConclusionrFVIIa was effective in treating refractory bleeding after cardiac surgery, reducing blood loss and transfusion requirements and restoring blood parameters to normal.

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