Abstract
We report the successful use of recombinant activated factor VII (rFVIIa) infusion in an 18-year-old man who underwent L3 laminectomy and pedicular screw fixation with severe refractory bleeding secondary to severe coagulopathy, which had remained unresponsive to conventional medical and surgical therapies. However, the patient developed a thromboembolic complication presumably associated with the use of rFVIIa. Although rFVIIa provides a dramatic response in intractable bleeding, it may cause a thromboembolic phenomenon which should be vigilantly considered and promptly treated.
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References
B Kenneth Daivid R Bruno W Brian (2005) ArticleTitleRecombinant factor VIIa as adjunctive therapy for bleeding control in severely injured trauma patients: two parallel randomized, placebo-controlled, double blind clinical trials J Trauma Inj Infection & Crit Care 59 8–18 Occurrence Handle10.1097/01.TA.0000171453.37949.B7
J Lusher J Ingerslev H Roberts (1998) ArticleTitleClinical experience with recombinant factor VIIa Blood Coagul Fibrinolysis 9 S119–128
U Hedner (1998) ArticleTitleRecombinant activated factor VII as a universal hemostatic agent Blood Coagul Fibrinolysis 9 IssueIDSuppl II S147–157 Occurrence Handle9819047 Occurrence Handle1:CAS:528:DyaK1cXnsVCitr0%3D
HGD Hendriks K Meijer JTHM de Wolf (2001) ArticleTitleReduced transfusion requirements by recombinant factor VII a in orthotopic liver transplantation, a pilot study Transplantation 71 402–405 Occurrence Handle11233901 Occurrence Handle10.1097/00007890-200102150-00011 Occurrence Handle1:CAS:528:DC%2BD3MXhvFegsLc%3D
C Barnes V Blanchette P Canning M Carcao (2005) ArticleTitleRecombinant FVIIa in the management of intracerebral haemorrhage in severe thrombocytopenia unresponsive to platelet-enhancing treatment Transfus Med 15 145–150 Occurrence Handle15859982 Occurrence Handle10.1111/j.0958-7578.2005.00564.x Occurrence Handle1:STN:280:DC%2BD2M3is1emtw%3D%3D
NM O'Connell DJ Perry AT Hodgson (2003) ArticleTitleRecombinant FVIIa in the management of uncontrolled hemorrhage Transfusion 43 1711–1716 Occurrence Handle14641868 Occurrence Handle10.1046/j.0041-1132.2003.00577.x
RAE Deveras CM Kessler (2000) ArticleTitleReversal of warfarin induced excessive anticoagulation with recombinant factor VIIa concentrate Ann Intern Med 137 884–888
GT Gerotziafas C Zervas GM Gavrielidis (2002) ArticleTitleEffective hemostasis with rFVIIa treatment in two patients with severe thrombocytopenia and life-threatening hemorrhage Am J Hematol 69 219–222 Occurrence Handle11891811 Occurrence Handle10.1002/ajh.10056
A Billio E Morello G Amaddii (2002) ArticleTitleTreatment of refractory thrombocytopenic bleeding with rFVIIa: a case report Blood 100 83b
HR Roberts DM Monroe JA Oliver (1998) ArticleTitleNewer concepts of blood coagulation Haemophilia 4 331–334 Occurrence Handle9873750 Occurrence Handle10.1046/j.1365-2516.1998.440331.x Occurrence Handle1:STN:280:DyaK1M%2FptVCgtA%3D%3D
JM Lusher (2000) ArticleTitleInhibitor antibodies to factor VIII and factor IX: management Semin Thromb Hemost 26 179–188 Occurrence Handle10919411 Occurrence Handle10.1055/s-2000-9821 Occurrence Handle1:CAS:528:DC%2BD3cXltFOitLk%3D
U Hedner (2000) ArticleTitleNovoSeven as a universal haemostatic agent Blood Coagul Fibrinolysis 11 IssueIDSuppl 1 S107–S111 Occurrence Handle10850574 Occurrence Handle1:CAS:528:DC%2BD3cXktlGitr0%3D
S Culic (2003) ArticleTitleRecombinant factor VIIa for refractive haemorrhage in autoimmune idiopathic thrombocytopenic purpura Br J Haematol 120 909–910 Occurrence Handle12614230 Occurrence Handle10.1046/j.1365-2141.2003.04151_2.x
R Klamroth S Gottstein H Landgraf (2002) ArticleTitleSuccessful use of recombinant factor VIIa to prevent bleeding during major surgery in a patient with severe immune thrombocytopenia Blood 100 77b
M Kjalke M Johannessen U Hedner (2001) ArticleTitleEffect of recombinant factor VIIa (Novoseven) on thrombocytopenia-like conditions in vitro Semin Hematol 38 4 IssueIDSuppl 12 15–20 Occurrence Handle10.1016/S0037-1963(01)90142-8
BR Saxon D Shanks CB Jory (2001) ArticleTitleEffective prophylaxis with daily recombinant factor VIIa (rFVIIa-Novoseven) in a child with high titre inhibitors and a target joint Thromb Haemost 86 1126–1127 Occurrence Handle11686341 Occurrence Handle1:CAS:528:DC%2BD3MXnvVeru74%3D
HGD Hendriks MAA Van der Maaten J de Wolf (2001) ArticleTitleAn effective treatment of severe intractable bleeding after valve repair by one single dose of activated recombinant factor VII Anesth Analg 93 287–289 Occurrence Handle11473845 Occurrence Handle10.1097/00000539-200108000-00009 Occurrence Handle1:STN:280:DC%2BD3MvjtFartA%3D%3D
T Haas P Innerhofer G Kuhbacher (2005) ArticleTitleSuccessful reversal of deleterious coagulopathy by recombinant factor VIIa Anesth Analg 100 54–58 Occurrence Handle15616051 Occurrence Handle10.1213/01.ANE.0000138064.12583.F6 Occurrence Handle1:CAS:528:DC%2BD2cXhtFeju77M
SA Mayer NC Brun K Begtrup (2005) ArticleTitleRecombinant activated factor VII for acute intracerebral hemorrhage New Engl J Med 352 777–785 Occurrence Handle15728810 Occurrence Handle10.1056/NEJMoa042991 Occurrence Handle1:CAS:528:DC%2BD2MXhsFCiur0%3D
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Khan, Z., Soltani, A. & Rahmani, P. Postoperative pulmonary thromboembolism possibly associated with recombinant activated factor VII infusion for the treatment of uncontrolled hemorrhage during vertebral instrumentation. J Anesth 21, 258–260 (2007). https://doi.org/10.1007/s00540-006-0481-y
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DOI: https://doi.org/10.1007/s00540-006-0481-y