Fatal thrombosis after administration of activated prothrombin complex concentrates in a patient supported by extracorporeal membrane oxygenation who had received activated recombinant factor VII

Bui, Jack D.; Despotis, George; Trulock, Elbert P.; Patterson, G. Alexander; Goodnough, Lawrence T.

doi:10.1067/mtc.2002.126038

Cited by 131 publications

(80 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our patient is the first adult reported in the literature who received rFVIIa on ECMO following heart surgery. The intracardiac thrombosis in our patient might have been initiated by a thrombogenic interaction between rFVIIa and APCC, as reported in the lung transplant patient (6). The inguinal and mediastinal mycotic infection could also have promoted the hypercoagulable state (1).…”

Section: Discussionmentioning

confidence: 52%

Fatal Outcome of Recombinant Factor VIIa in Heart Transplantation With Extracorporeal Membrane Oxygenation

Syburra

Lachat

Genoni

et al. 2010

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 52%

Fatal Outcome of Recombinant Factor VIIa in Heart Transplantation With Extracorporeal Membrane Oxygenation

Syburra

Lachat

Genoni

et al. 2010

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

“…Reports suggest that the increased production of thrombin after rf-VIIa administration may lead to thrombus formation in patients with vulnerable atherosclerotic plaques (24) or a freshly damaged endothelial surface. Thrombosis of extracorporeal membrane oxygenation circuits was reported by several groups (3,22).…”

Section: Complications (Table 5)mentioning

confidence: 99%

Safety and efficiency of recombinant activated factor VII in postcardiotomy massive hemorrhage

Lamarche¹,

Demers²,

Poirier³

et al. 2007

Canadian Journal of Cardiology

View full text Add to dashboard Cite

“…Indeed, 2 of the 20 patients (10%) who received rFVIIa following extracorporeal circulation experienced thromboembolic events, and such an event was suspected in a third patient. 20,21,27 Both patients who developed thromboembolic events hemorrhaged following lung transplantation. 21,27 One patient was believed to have experienced massive intracardiac and extracorporeal membrane oxygenation circuit thromboses following the administration of both rFVIIa and activated prothrombin complex concentrates; this patient developed cardiac arrest and died.…”

Section: Pitfalls and Risks Of Rfviia Usementioning

confidence: 99%

“…16 -28 The patients who received rFVIIa ranged in age from 12 days to 75 years and included 13 male patients and 7 female patients. Six patients had undergone valve replacement and/or repair, 16,17,20,23 four patients had undergone valve replacement with aortic root repair/replacement, 16,22 two patients had undergone arterial switch operations, 16,28 two patients had undergone lung transplant operations, 21,27 and two patients had undergone repair of an aortic aneurysm. 26 Additionally, repair of the atrioventricular canal, 25 placement of a biventricular assist device, 18 coronary artery bypass surgery, 19 and repair of an atrial septal defect were each performed in one patient.…”

Section: Published World Experiencementioning

confidence: 99%

Use of Recombinant Activated Factor VII for Bleeding Following Operations Requiring Cardiopulmonary Bypass

DiDomenico

Massad

Kpodonu

et al. 2005

Chest

View full text Add to dashboard Cite

Postoperative bleeding is a common complication following cardiothoracic surgical procedures requiring cardiopulmonary bypass (CPB). Serious bleeding complications requiring the administration of blood products, hemostatic drugs, and even repeat surgery are associated with considerable morbidity, mortality, and resource consumption. Therapy with recombinant activated factor VII (rFVIIa) may be an effective treatment strategy for patients with refractory bleeding. We report the successful use of rFVIIa for the treatment of intractable postoperative bleeding following aortic aneurysm repair in two patients with Marfan syndrome. In both patients, surgical reexploration was avoided, and the patients' clinical status was stabilized after the administration of rFVIIa. In one patient, hemostasis was rapidly achieved within minutes, whereas hemostasis occurred gradually over several hours in the second patient. Including our personal experience with the two cases, the use of rFVIIa has been reported in 20 patients who required CPB for cardiothoracic surgical procedures. Hemostasis was achieved in all patients. In 14 patients (70%), rapid hemostasis was achieved following a single dose of rFVIIa (mean dose, 57 g/kg). In the remaining six patients, gradual hemostasis was achieved after a mean of 3.4 doses (mean cumulative dose, 225 g/kg). Two patients (10%) were believed to have experienced thromboembolic complications after the administration of rFVIIa (one was fatal), and, in another patient, intracoronary thrombosis was suspected but was not confirmed. In patients experiencing postoperative bleeding complications that are refractory to treatment with blood products, hemostatic agents, and/or repeat surgery, the use of rFVIIa may be considered. (CHEST 2005; 127:1828 -1835)Key words: cardiopulmonary bypass; extracorporeal support; postoperative bleeding; recombinant activated factor VII Abbreviations: CPB ϭ cardiopulmonary bypass; rFVIIa ϭ recombinant activated factor VII P ostoperative bleeding is one of the most common complications following cardiopulmonary bypass (CPB) in patients undergoing cardiothoracic surgical procedures. Treatment strategies for postoperative bleeding include supportive care with volume resuscitation, the administration of blood products, pharmacologic intervention, and surgical reexploration. Massive hemorrhage requiring surgical reexploration occurs in about 6% of the patients and is associated with considerable morbidity and mortality. 1,2 Surgical reexploration due to excessive bleeding has been associated with a threefold to fourfold increase in mortality and with multiple morbidities, including renal failure, sepsis, atrial arrhythmias, prolonged mechanical ventilatory support, and increased length of hospital stay. 3 Thus, safe and effective strategies to prevent and treat postoperative bleeding are crucial. Limitations of Currently Available Pharmacologic AgentsBlood products are often used to correct the anemia that ensues and to promote hemostasis. Fresh-frozen plasma, pooled platelet...

show abstract

Fatal thrombosis after administration of activated prothrombin complex concentrates in a patient supported by extracorporeal membrane oxygenation who had received activated recombinant factor VII

Cited by 131 publications

References 4 publications

Fatal Outcome of Recombinant Factor VIIa in Heart Transplantation With Extracorporeal Membrane Oxygenation

Fatal Outcome of Recombinant Factor VIIa in Heart Transplantation With Extracorporeal Membrane Oxygenation

Safety and efficiency of recombinant activated factor VII in postcardiotomy massive hemorrhage

Use of Recombinant Activated Factor VII for Bleeding Following Operations Requiring Cardiopulmonary Bypass

Contact Info

Product

Resources

About