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To describe rFVIIa dosing and clinical outcomes in cardiovascular surgery patients with refractory bleeding.
This study compared the efficacy and risk of adverse events of rFVIIa and FEIBA in cardiac surgical patients with refractory bleeding.
Six patients had massive refractory bleeding.
Therefore, we conclude that rFVIIa may be used to control refractory bleeding in patients receiving ECMO.
Given concerns regarding adverse effects of blood product transfusion and limited efficacy of current antifibrinolytics, procoagulant medications, including recombinant factor VIIa (rFVIIa) and factor eight inhibitor bypass activity (FEIBA), increasingly have been used in managing refractory bleeding.
To review the efficacy, safety, and dose of recombinant activated factor VII in off-label management of refractory bleeding in pediatric patients with congenital heart disease undergoing cardiac surgery with cardiopulmonary bypass.
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This is used in the treatment of refractory ascites, bleeding from oesophageal varices and hepatorenal syndrome.
rFVIIa-refractory bleeding requires immediate measures of bleeding control (reoperation, packing, intraoperative interventional catheter procedures, and so on) to maintain the chance of survival.
In the case of massive post-CPB bleeding refractory to standard hemostatic therapy, the administration of rFVIIa may be taken into consideration.
The congenital Cardiac Anesthesia Society (CCAS) Task Force recommends that rFVIIa can be considered for the management of post-CPB bleeding refractory to maximal standard hemostatic therapy in pediatric cardiac surgery [3].
Life-threatening bleeding refractory to platelet support.
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