Early use of recombinant factor VIIa improves mean arterial pressure and may potentially decrease mortality in experimental hemorrhagic shock: A pilot study

Mauricio Lynn, Igor Jerokhimov, Dory Jewelewicz, Charles Popkin, Edward W. Johnson, Qammar N. Rashid, Margareth Brown, Uri Martinowitz, Stephen M. Cohn

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Background: Recombinant factor VIIa (rFVIIa) is used for treatment of bleeding episodes in hemophilia patients who develop inhibitors to factors VIII and IX. We tested the hypothesis that administration of rFVIIa early after injury would decrease bleeding and improve survival after experimental hepatic trauma. Methods: Anesthetized swine were cannulated for blood sampling and hemodynamic monitoring. Avulsion of left median lobe of the liver induced uncontrolled hemorrhage. After a 10% reduction of mean arterial pressure, animals were blindly randomized to receive intravenous rFVIIa (180 μg/kg) (n = 6) or placebo (n = 7). Results: Mortality was 43% (three of seven) in controls versus 0% with rFVIIa (p = 0.08, Χ2). Significantly shorter prothrombin time and higher mean arterial pressures were observed in the rFVIIa group. Conclusion: Intravenous administration of rFVIIa early after induction of hemorrhage shortens prothrombin time and improves mean arterial pressure. A trend toward improved survival was observed.

Original languageEnglish (US)
Pages (from-to)703-707
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume52
Issue number4
StatePublished - 2002
Externally publishedYes

Fingerprint

Hemorrhagic Shock
Arterial Pressure
Mortality
Hemorrhage
Prothrombin Time
Factor IX
Survival
Liver
Wounds and Injuries
Factor VIII
Hemophilia A
Intravenous Administration
recombinant FVIIa
Swine
Hemodynamics
Placebos

Keywords

  • Factor VIIa
  • Hemorrhagic shock
  • Liver injury
  • Trauma

ASJC Scopus subject areas

  • Surgery

Cite this

Early use of recombinant factor VIIa improves mean arterial pressure and may potentially decrease mortality in experimental hemorrhagic shock : A pilot study. / Lynn, Mauricio; Jerokhimov, Igor; Jewelewicz, Dory; Popkin, Charles; Johnson, Edward W.; Rashid, Qammar N.; Brown, Margareth; Martinowitz, Uri; Cohn, Stephen M.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 52, No. 4, 2002, p. 703-707.

Research output: Contribution to journalArticle

Lynn, M, Jerokhimov, I, Jewelewicz, D, Popkin, C, Johnson, EW, Rashid, QN, Brown, M, Martinowitz, U & Cohn, SM 2002, 'Early use of recombinant factor VIIa improves mean arterial pressure and may potentially decrease mortality in experimental hemorrhagic shock: A pilot study', Journal of Trauma - Injury, Infection and Critical Care, vol. 52, no. 4, pp. 703-707.
Lynn, Mauricio ; Jerokhimov, Igor ; Jewelewicz, Dory ; Popkin, Charles ; Johnson, Edward W. ; Rashid, Qammar N. ; Brown, Margareth ; Martinowitz, Uri ; Cohn, Stephen M. / Early use of recombinant factor VIIa improves mean arterial pressure and may potentially decrease mortality in experimental hemorrhagic shock : A pilot study. In: Journal of Trauma - Injury, Infection and Critical Care. 2002 ; Vol. 52, No. 4. pp. 703-707.
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AU - Lynn, Mauricio

AU - Jerokhimov, Igor

AU - Jewelewicz, Dory

AU - Popkin, Charles

AU - Johnson, Edward W.

AU - Rashid, Qammar N.

AU - Brown, Margareth

AU - Martinowitz, Uri

AU - Cohn, Stephen M.

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AB - Background: Recombinant factor VIIa (rFVIIa) is used for treatment of bleeding episodes in hemophilia patients who develop inhibitors to factors VIII and IX. We tested the hypothesis that administration of rFVIIa early after injury would decrease bleeding and improve survival after experimental hepatic trauma. Methods: Anesthetized swine were cannulated for blood sampling and hemodynamic monitoring. Avulsion of left median lobe of the liver induced uncontrolled hemorrhage. After a 10% reduction of mean arterial pressure, animals were blindly randomized to receive intravenous rFVIIa (180 μg/kg) (n = 6) or placebo (n = 7). Results: Mortality was 43% (three of seven) in controls versus 0% with rFVIIa (p = 0.08, Χ2). Significantly shorter prothrombin time and higher mean arterial pressures were observed in the rFVIIa group. Conclusion: Intravenous administration of rFVIIa early after induction of hemorrhage shortens prothrombin time and improves mean arterial pressure. A trend toward improved survival was observed.

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