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Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
Published on: September 9, 2012
Thromboembolic complications associated with factor VIIa administration.
G O Rhys Thomas1, Richard P Dutton, Bethany Hemlock
1R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, MD 21201, USA.
The Journal of Trauma
|April 7, 2007
Summary
Recombinant activated Factor VII (rFVIIa) use in trauma patients was associated with a 9.4% rate of thromboembolic complications. Caution is advised, especially in patients with arterial injuries, due to potential thrombosis risks.
Area of Science:
- Trauma and Emergency Medicine
- Hematology
- Pharmacology
Background:
- Factor VIIa (FVIIa) is administered to control bleeding in trauma patients with coagulopathy.
- The incidence and risk factors for thromboembolic complications associated with FVIIa are not well-established.
Purpose of the Study:
- To investigate the incidence of thromboembolic events following FVIIa administration.
- To identify patient populations at risk for FVIIa-associated thromboembolic complications.
Main Methods:
- Retrospective review of 285 patient records who received FVIIa between 2001 and 2006.
- Documentation of thromboembolic events, indication for FVIIa, timing, and outcomes.
- Expert panel assessment of FVIIa's contribution to events and outcomes.
Main Results:
- Thromboembolic complications occurred in 9.4% of patients (27/285).
- Nine events were highly related to FVIIa; 10 of 14 deaths were partly attributed to thrombotic complications.
- Eighteen events, including cardiovascular accidents and mesenteric ischemia, resulted from FVIIa combined with vascular injury.
Conclusions:
- FVIIa is a potent procoagulant with a risk of adverse thromboembolic events.
- Administration of FVIIa requires caution in patients with arterial injuries.
- Mesenteric and cerebral vessels may be particularly vulnerable to FVIIa-induced thrombosis.
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