Klinische Bewertung potentieller Einsatzbereiche von rekombinantem Faktor VIIa bei internistischen und pädiatrischen Erkrankungen

Abstract

Recombinant factor VIIa (rFVIIa) is increasingly used outside the labeled indications for treatment of life-threatening bleeding episodes after failure of the respective standard therapy. An interdisciplinary group of experts summarizes the state of knowledge of the use of rFVIIa in gastroenterology and hepatology, thrombocytopenia and -pathia, coagulation factor deficiencies, von Willebrand's disease, periinterventional bleeding without specific bleeding diathesis, drug-induced bleeding, disseminated intravascular coagulation, and neonatology. The most commonly used dose is 90 microg/kg body weight rFVIIa as bolus, if necessary followed by additional injections at intervals of 2-3 h. In factor VII deficiency lower dosages of 15-30 microg/kg body weight of rFVIIa are given every 4-6 h, whereas higher doses of 150-200 microg/kg body weight are used in neonates.

The neonatal coagulation system and the vitamin K deficiency bleeding – a mini review

“…Dempfle et al [65] summarize 28 bleeding episodes in 27 neonates (nine different papers), the publications of Brady et al and Hünseler et al, however, are not included. Brady et al [66] treated nine infants (two thereof with vitamin K deficiency and intracranial bleeding), Hünseler et al [67] three cases.…”