Use of Recombinant Activated Factor VII (Novoseven) in Trauma and Surgery: Analysis of Outcomes Reported to an International Registry

Author:

Grounds R. Michael1,Seebach Caroline2,Knothe Christoph3,Paluszkiewicz Piotr4,Smith Terry S.5,Kasal Eduard6,Lecumberri Ramon7,Urbanec Rene8,Haas Thorsten9,Wujtewicz Maria10,Rehorkova Dagmar11,Pelichovska Martina12,Lange Martina13,Uranga Maite14,Bosman Roman15,Rommes J. Hans16,Koscielny Juergen17

Affiliation:

1. Anaesthesia and Intensive Care Medicine, St George's Hospital, Tooting, London, UK

2. Department of Traumatology, Johann Wolfgang Goethe University, Frankfurt am Main

3. Anaesthesiology & Intensive Care, Klinikum Rosenheim, Germany

4. Department of General Surgery, St Johns Hospital, University Medical School, Lublin, Poland

5. Department of Critical Care Medicine, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada

6. Anaesthesia & Intensive Department, Charles University Hospital, Alej Svobody, Czech Republic

7. Hematology Service, University Clinic of Navarra, Pamplona, Spain

8. Department of Resuscitation and Anaesthesia, Ostrava Faculty Hospital, Poruba, Czech Republic

9. Department of Anaesthesiology and Critical Care Medicine, Innsbruck, Austria

10. Department of Anaesthesiology and Intensive Therapy, Medical University Gdańsk, Gdańsk, Poland

11. Department of Anaesthesiology & Critical Care Medicine, Traumatological Hospital Brno, Brno, Czech Republic

12. ICU Clinic of Anaesthesia & Resusitation, 2nd Medical Faculty Hospital Motol, Prague, Czech Republic

13. R. Elle Hospitasl, Eisenberg, Germany

14. Haematology Service, Hospital Donosti, Donosti-San Sebastian, Spain

15. Charles Teaching Hospital, Lochodin, Czech Republic

16. Department of Intensive Care, Apeldoorn

17. Institute for Transfusion Medicine, Charité Humboldt University, Campus Charité Mitte, Berlin, Germany

Abstract

The objective was to evaluate the efficacy and safety of recombinant activated factor VII in patients with massive bleeding. Forty-five patients with severe massive hemorrhage requiring= 14 transfusion units of packed red blood cells received recombinant activated factor VII. Postdrug blood loss and transfusion requirements were assessed, and mortality was compared with predicted outcomes. Blood loss was markedly reduced in 40 of 43 (93.0%) patients, and transfusion requirements decreased after recombinant activated factor VII administration. Mortality rate in trauma patients who had massive hemorrhage was significantly reduced compared with predictions using scoring systems. This may be associated with the use of recombinant activated factor VII. This study failed to demonstrate an improvement in surgical patients. The absence of concurrent controls prevents definitive conclusions regarding actual safety or efficacy of recombinant activated factor VII.

Publisher

SAGE Publications

Subject

Critical Care and Intensive Care Medicine

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