A novel hemostatic agent: the potential role of recombinant activated factor VII (rFVIIa) in anesthetic practice. Export

@article{citeulike:3151715, abstract = {PURPOSE: To review the role of recombinant factor VIIa in anesthetic practice. SOURCE: A review of the published literature. MAIN FINDINGS: The mechanism of action of rFVIIa suggests enhancement of hemostasis limited to the site of injury without systemic activation of the coagulation cascade. In addition to its indication for use in patients with hemophilia, use of rFVIIa for treatment of uncontrolled massive hemorrhage in various peroperative settings appears to be rational, safe, and effective. Published results suggest that in trauma patients rFVIIa may play a role as an adjunctive hemostatic measure in addition to surgical hemostatic techniques There is preliminary evidence that hemorrhagic complications (eg. epistaxis, vaginal bleeding) associated with profound thrombocytopenia can be reversed with rFVIIa even at platelet counts below 10,000 per microL. Various case reports outlining the successful treatment with recombinant factor VIIa of patents experiencing intractable bleeding after valve replacement surgery, and with severe hemorrhage during therapy with left ventricular assist device, indicate the potential therapeutic efficacy of this agent in cardiac surgical procedures. Additionally, rFVIIa has been used successfully for treatment of massive postoperative bleeding following general surgery. CONCLUSIONS: rFVIIa is a novel hemostatic agent that shows promise in non-hemophiliac patents of a significant therapeutic role in variety of coagulopathic and hemorrhagic conditions in clinical situations ranging from thrombocytopenia, disseminated intravascular coagulation and transfusion-related coagulopathy, as well as in patients experiencing massive blood loss undergoing orthotopic liver transplantation, cardiac, orthopedic and genitourinary surgery.}, address = {Department of Anesthesiology, University of Western Ontario, London, Canada. jmurkin@uwo.ca}, author = {Murkin, J. M.}, citeulike-article-id = {3151715}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/12546007}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=12546007}, issn = {0832-610X}, journal = {Canadian journal of anaesthesia = Journal canadien d'anesth\'{e}sie}, keywords = {factor7}, month = {December}, number = {10}, posted-at = {2008-08-24 01:33:40}, priority = {2}, title = {A novel hemostatic agent: the potential role of recombinant activated factor VII (rFVIIa) in anesthetic practice.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/12546007}, volume = {49}, year = {2002} }

TY - JOUR ID - citeulike:3151715 L3 - citeulike-article-id:3151715 N2 - PURPOSE: To review the role of recombinant factor VIIa in anesthetic practice. SOURCE: A review of the published literature. MAIN FINDINGS: The mechanism of action of rFVIIa suggests enhancement of hemostasis limited to the site of injury without systemic activation of the coagulation cascade. In addition to its indication for use in patients with hemophilia, use of rFVIIa for treatment of uncontrolled massive hemorrhage in various peroperative settings appears to be rational, safe, and effective. Published results suggest that in trauma patients rFVIIa may play a role as an adjunctive hemostatic measure in addition to surgical hemostatic techniques There is preliminary evidence that hemorrhagic complications (eg. epistaxis, vaginal bleeding) associated with profound thrombocytopenia can be reversed with rFVIIa even at platelet counts below 10,000 per microL. Various case reports outlining the successful treatment with recombinant factor VIIa of patents experiencing intractable bleeding after valve replacement surgery, and with severe hemorrhage during therapy with left ventricular assist device, indicate the potential therapeutic efficacy of this agent in cardiac surgical procedures. Additionally, rFVIIa has been used successfully for treatment of massive postoperative bleeding following general surgery. CONCLUSIONS: rFVIIa is a novel hemostatic agent that shows promise in non-hemophiliac patents of a significant therapeutic role in variety of coagulopathic and hemorrhagic conditions in clinical situations ranging from thrombocytopenia, disseminated intravascular coagulation and transfusion-related coagulopathy, as well as in patients experiencing massive blood loss undergoing orthotopic liver transplantation, cardiac, orthopedic and genitourinary surgery. IS - 10 JF - Canadian journal of anaesthesia = Journal canadien d'anesthésie SN - 0832-610X AD - Department of Anesthesiology, University of Western Ontario, London, Canada. jmurkin@uwo.ca TI - A novel hemostatic agent: the potential role of recombinant activated factor VII (rFVIIa) in anesthetic practice. VL - 49 KW - factor7 AU - Murkin, JM PY - 2002/12// UR - http://view.ncbi.nlm.nih.gov/pubmed/12546007 ER -