Use of Recombinant Activated Factor VII for Bleeding in Pancreatitis

Abstract

This case series indicates that rFVIIa may be an effective hemostatic treatment of patients with pancreatitis suffering from massive bleeding. There were no thromboembolic events in any patient, including those with sepsis or DIC.

Evaluation of Recombinant Factor VIIa Off-Label Use at an Acute Care Hospital with Established Guidelines for Use

“…This number may be impacted by data indicating that rFVIIa successfully reduced hemorrhage size at higher doses (ie, 80 mcg/kg/dose) with no improvement in functional outcome or survival. 6,7 The vast majority of patients 163 (90%) received 2 or fewer doses of rFVIIa. The guidelines have focused on the use of conventional hemostatic agents when possible and minimized the dose and number of repeat doses of rFVIIa to that which has been supported by literature.…”

Unlabeled uses of factor VIIa (recombinant) in pediatric patients

“…[54][55][56][57] These indications included severe coagulopathy and intracerebral hemorrhages from hepatic injury secondary to echovirus infection, continuous rectal bleeding associated with hemophagocytic lymphohistiocytosis, and pericardial hemorrhage associated with necrotizing pancreatitis. One to three doses of factor VIIa (recombinant) 80-90 µg/kg were administered, in addition to blood products.…”

“…Bleeding cessation was observed in the other patients; however, bleeding resumed within 24 hours in three of four patients. [55][56][57] Twenty case reports described the use of factor VIIa (recombinant) in patients undergoing various types of surgery. [59][60][61][62][63][64][65][66][67][68] Seven reports described patients who underwent cardiac surgery.…”

Efficacy of recombinant activated Factor VII in patients with massive uncontrolled bleeding: a retrospective observational analysis

“…There are multiple case reports on the administration of rFVIIa when conventional therapy failed to stop blood loss. Case series on intraabdominal hemorrhage, massive obstetric hemorrhage, bleeding in pancreatitis, massive bleeding after lung resection, and hemorrhage after massive trauma indicate less bleeding after infusion of rFVIIa, improvement of coagulation variables, and reduction of transfusion requirements 2,17‐20 . Since 2004 we have used rFVIIa to control massive bleeding when conventional therapy failed.…”