Combined Use of Recombinant Activated Factor VII and ECMO in Severe Postoperative Bleeding after Cardiac Surgery in a Newborn: Death due to Ventricular Dysfunction

Safety and efficacy of recombinant activated factor VII for refractory hemorrhage in pediatric patients on extracorporeal membrane oxygenation: a single center review

“…12,13 In the pediatric patient on ECMO with severe hemorrhage, some case reports and retrospective reviews have shown improved hemostasis after its use, without severe thrombotic complications. 16 , 18–28…”

“…Other literature, using rFVIIa for hemorrhage while on ECMO, utilizes doses from 24 – 174 μg/kg (most commonly 90 μg/kg), with the total number of doses given per treatment episode from 1-4 and typical dosing intervals of every 1-4 hours. 16,19–28,36,38–43 A Cochrane Review in 2007 showed large variability in dosing and schedules, with an equally diverse group of patients, indications and co-interventions. 17 It is unclear whether there is a dose-effect relationship when utilizing rFVIIa.…”