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Recombinant activated factor VII in children with acute bleeding resulting from liver failure and disseminated

A Chuansumrit1, T Chantarojanasiri, P Isarangkura

  • 1Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. raajs@mahidol.ac.th

Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis
|June 13, 2000
PubMed

Insights

Recombinant activated factor VII (rFVIIa) effectively controlled acute bleeding in children with liver failure and DIC. This hemostatic agent showed promising results in pediatric patients requiring urgent intervention.

Area of Science:

  • Pediatric Hematology
  • Critical Care Medicine
  • Pharmacology

Background:

  • Acute bleeding in children with liver failure and disseminated intravascular coagulation (DIC) presents significant management challenges.
  • Limited therapeutic options exist for controlling severe hemorrhage in this vulnerable population.
  • Recombinant activated factor VII (rFVIIa) is a procoagulant agent with potential applications in severe bleeding scenarios.

Observation:

  • Three pediatric cases with acute bleeding due to liver failure and DIC were treated with rFVIIa.
  • Cases involved Dengue hemorrhagic fever with shock and post-hepatectomy complications including liver/renal impairment.
  • rFVIIa was administered as a bolus followed by continuous infusion, alone or with blood products.

Findings:

  • All three patients experienced controlled bleeding following rFVIIa administration.
  • Significant improvements were observed in prothrombin time and FVII clotting activity.
  • rFVIIa demonstrated efficacy as a hemostatic agent in these complex pediatric cases.

Implications:

  • rFVIIa may be a valuable therapeutic option for managing acute bleeding in pediatric patients with liver failure and DIC.
  • Further research is warranted to establish optimal dosing and long-term outcomes.
  • This study highlights the potential of targeted procoagulant therapy in critical pediatric hematology.

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