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Recombinant activated factor VII for uncontrolled bleeding postcardiac surgery.

Aly Makram Habib1, Ahmed Yehia Mousa2, Zohair Al-Halees3

  • 1Cardiac Surgical Intensive Care Unit, King Faisal Heart Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Department of Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.

Journal of the Saudi Heart Association
|October 1, 2016
PubMed
Summary
This summary is machine-generated.

Recombinant activated factor VII (rFVIIa) effectively reduced chest tube bleeding and blood product transfusions in patients with severe post-cardiac surgery hemorrhage. However, its safety profile requires further investigation in controlled trials.

Keywords:
BleedingCardiac surgeryrFVIIa

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Area of Science:

  • Cardiology
  • Hematology
  • Surgical Critical Care

Background:

  • Persistent hemorrhage after cardiac surgery poses significant risks.
  • Conventional treatments may not always suffice for severe bleeding.
  • Recombinant activated factor VII (rFVIIa) is a potential therapeutic option.

Purpose of the Study:

  • To evaluate the safety and efficacy of rFVIIa in managing persistent hemorrhage post-cardiac surgery.
  • To compare outcomes between patients receiving rFVIIa and those receiving conventional treatment.

Main Methods:

  • Retrospective observational study design.
  • Two groups: control (conventional treatment) and rFVIIa (conventional treatment + rFVIIa).
  • Inclusion criteria: bleeding ≥ 3 ml/kg/h for 2 consecutive hours post-cardiac surgery.

Main Results:

  • rFVIIa significantly decreased chest tube output at 4 and 9 hours post-CSICU admission compared to controls.
  • Fewer blood products were transfused in the rFVIIa group (3-12 hours post-CSICU).
  • Reexploration rates were lower in the rFVIIa group (p=0.01), but Thromboembolic Adverse Events (TAE) showed no significant difference (p=0.27).

Conclusions:

  • rFVIIa successfully reduced chest tube bleeding and blood product transfusion in severe post-cardiac surgical bleeding.
  • The safety of rFVIIa in this context remains uncertain.
  • Further prospective controlled trials are necessary to confirm the role and safety of rFVIIa.