Characteristics Associated With Mortality in 372 Patients Receiving Low-Dose Recombinant Factor VIIa (rFVIIa) for Cardiac Surgical Bleeding

Baral, Perel; Cotter, Elizabeth; Gao, Guangyi; He, Jia; Wirtz, Katy; Sharma, Abhıshek; Zorn, Trip; Muehlebach, Gregory; Flynn, Brigid C.

doi:10.1053/j.jvca.2019.01.047

Cited by 6 publications

(2 citation statements)

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“…However, the use of rFVIIa for cardiac surgical bleeding has also been associated with increased mortality [9], thrombosis [10][11][12], stroke [8,12,13] and renal morbidity [9,10]. Thus, use of very-low-dose rFVIIa (vld-rFVIIa) in adult cardiac surgery has been recently investigated [2,6,7,14,15].…”

Section: Introductionmentioning

confidence: 99%

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Very low-dose recombinant Factor VIIa administration for cardiac surgical bleeding reduces red blood cell transfusions and renal risk: a matched cohort study

Cotter¹,

Sharma

Campton

et al. 2021

Blood Coagulation &Amp; Fibrinolysis

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Outcomes following administration of very-low-dose recombinant activated factor VIIa (vld-rFVIIa) for cardiac surgical bleeding remain debatable. We sought to determine the association of vld-rFVIIa and adverse surgical outcomes. Retrospective, cohort matching of patients undergoing cardiac surgery who received vld-rFVIIa (median 13.02 μg/kg) for perioperative bleeding were matched to cardiac surgical patients who had bleeding and received standard of care for bleeding without Factor VIIa administration. Of the 362 matched patients (182 in each group), patients who received rFVIIa required significantly less red blood cell transfusions [median 3 units (range 0--60, IQR = 4 units) versus 4 units (range 2-34, IQR = 4 units); P = 0.0004], decreased length of hospital stay (median 8 versus 9 days; P = 0.0158) and decreased renal risk (P < 0.0001). Incidence of renal failure, postoperative infection, postoperative thrombosis, prolonged ventilation, total ICU hours and 30-day mortality were not different between the two groups. Vld-rFVIIa for cardiac surgical bleeding was associated with decreased red blood cell transfusion, renal risk and length of hospital stay without increased thromboembolism or mortality when compared to patients who had cardiac surgical bleeding and received standard of care without Factor VIIa.

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Section: Introductionmentioning

confidence: 99%

“…Previous reports for cardiac surgical bleeding describe administration of very low-dose rFVIIa (vld-rFVIIa) consisting of median doses of 12-50 mg/kg [14][15][16][17][18]. These trials showed various benefits with potentially less risk of adverse outcomes.…”

Section: Introductionmentioning

confidence: 99%