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Updated: Jun 22, 2026
08:13
Tail Vein Transection Bleeding Model in Fully Anesthetized Hemophilia A Mice
Published on: September 30, 2021
Activated recombinant factor VII for refractory bleeding during extracorporeal membrane oxygenation
Robert A Niebler1, Rowena C Punzalan, Marisela Marchan
1Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. rniebler@mcw.edu
Summary
Activated recombinant factor VII (rFVIIa) use during extracorporeal membrane oxygenation (ECMO) reduced bleeding severity without increasing thromboembolic events. This finding supports rFVIIa as a potential treatment for bleeding in critically ill patients on ECMO.
Area of Science:
- Pediatric critical care medicine
- Hematology
- Cardiopulmonary support
Background:
- Extracorporeal membrane oxygenation (ECMO) is a life-support measure for critically ill patients with severe cardiopulmonary failure.
- Bleeding complications are a significant concern in patients undergoing ECMO therapy.
- Activated recombinant factor VII (rFVIIa) has been explored as a hemostatic agent in various bleeding scenarios.
Purpose of the Study:
- To evaluate the safety and efficacy of activated recombinant factor VII (rFVIIa) in pediatric patients receiving extracorporeal membrane oxygenation (ECMO) support.
- To determine the frequency of adverse events, specifically thromboembolic complications, associated with rFVIIa use during ECMO.
- To quantify the impact of rFVIIa on bleeding parameters in ECMO patients.
Main Methods:
- Retrospective case series conducted at a tertiary academic children's hospital.
- Analysis included 17 pediatric patients who received rFVIIa during or shortly after ECMO initiation (February 2003 to August 2006).
- Comparison was made with 23 historical control patients who received ECMO prior to rFVIIa availability (January 1999 to December 2002).
Main Results:
- No significant differences were observed in thromboembolic complications, ECMO circuit failures, or mortality between the rFVIIa group and historical controls.
- A significant reduction in chest tube output and blood product transfusion requirements was noted within 5 hours of rFVIIa administration.
- No trend towards increased survival was identified, and circuit complications occurred in both groups.
Conclusions:
- Activated recombinant factor VII administration during ECMO support is associated with decreased bleeding severity.
- The use of rFVIIa in this context did not lead to an increased rate of thromboembolic complications.
- rFVIIa may be a valuable adjunct for managing bleeding in pediatric patients on ECMO.
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