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 journalArticlepeer-review

59 Scopus citations

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.MethodsAnesthetized 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 = 0.08,2). 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
Volume52
Issue number4
DOIs
StatePublished - Apr 2002

Keywords

  • Factor VIIa
  • Hemorrhagic shock
  • Liver injury
  • Trauma

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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