Clinical application of recombinant coagulation factor VIIa in the treatment of massive bleeding in surgical patients

Abstract

Background: Severe perioperative bleedings related to major surgeries pose a serious medical problem due to surgical treatment. NovoSeven (recombinant activated factor VII - rFVIIa, Novo Nordisk, Denmark) accelerates local haemostasis by an exogenous coagulation system, directly stimulating factor X.
Material i methods: Three cases of the successful use of rFVIIa in the Department of General and Vascular Surgery of Poznan University of Medical Sciences have been described. The first case refers to the controlling of bleeding from a surgical wound in a female patient with idiopathic thrombocytopenia. The two others refer to the application of rFVIIa in female patients, who previously did not present any signs of haemostatic disorders.
Results: In all the cases presented, shortly after the drug’s administration, bleeding symptoms abated as confirmed by normalisation of laboratory results and haemodynamic parameters, which standard treatments had failed to produce before.
Conclusions: It is important to note that all the patients were administered a lower dose of rFVIIa than recommended by the manufacturer and described by other authors, which may indicate that lower doses of rFVIIa are also efficient. As well as that, the concomitant use of FFP and rFVIIa allows the reduction of rFVIIa dosage.