Recombinant factor VIIa to control excessive bleeding following surgery for congenital heart disease in pediatric patients

Joseph D. Tobias, Janet M. Simsic, Samuel Weinstein, William Schechter, Vyas Kartha, Robert E. Michler

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

The purpose of this article is to evaluate the efficacy of recombinant factor VII (rFVIIa) in the treatment of bleeding following cardiac surgery in a pediatric population. The study included a case series of postcardiac surgical patients with chest tube output of= 4 mL/kg/h for the initial 3 postoperative hours who received rFVIIa. Chest tube output for the 3 hours before and the 3 hours after rFVIIa was compared using a pairedt test. In addition, chest tube output for the initial 3 postoperative hours and the 3 hours following rFVIIa was compared to 8 control patients who did not require rFVIIa. Recombinant factor VIIa was administered to 9 children (age = 9 ± 4 years) following repair of tetralogy of Fallot (6), closure of ventricular septal defect (1), closure of sinus venosus atrial septal defect (1), and mitral valve repair (1). Chest tube output for the initial 3 postoperative hours prior to the administration of rFVIIa was 5.8 ± 2.8 mL/kg/h and decreased to 2.0 ± 1.3 mL/kg/h for the 3 hours following the administration of rFVIIa (P=.002). In the patients that did not receive rFVIIa, chest tube output for the first 3 postoperative hours was 1.6 ± 0.9 mL/kg/h and 1.2 ± 0.6 mL/kg/h for the next 3 hours (P= nonsignificant when compared to chest tube output for the 3 hours following rFVIIa in patients who received rFVIIa). No adverse effects were noted. Recombinant factor VIIa decreased chest tubing bleeding following cardiac surgery in children. Given its potential therapeutic impact, rFVIIa warrants further investigation in the pediatric cardiac population.

Original languageEnglish (US)
Pages (from-to)270-273
Number of pages4
JournalJournal of Intensive Care Medicine
Volume19
Issue number5
DOIs
StatePublished - Sep 2004
Externally publishedYes

Fingerprint

Heart Diseases
Pediatrics
Hemorrhage
Chest Tubes
recombinant FVIIa
Thoracic Surgery
Factor VII
Tetralogy of Fallot
Ventricular Heart Septal Defects
Mitral Valve
Population
Thorax

Keywords

  • Chest tubing bleeding
  • Congenital heart disease
  • Pediatric cardiac patients
  • Recombinant factor VIIa

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Recombinant factor VIIa to control excessive bleeding following surgery for congenital heart disease in pediatric patients. / Tobias, Joseph D.; Simsic, Janet M.; Weinstein, Samuel; Schechter, William; Kartha, Vyas; Michler, Robert E.

In: Journal of Intensive Care Medicine, Vol. 19, No. 5, 09.2004, p. 270-273.

Research output: Contribution to journalArticle

@article{264843ac405d4e8fab538fb4e1f70864,
title = "Recombinant factor VIIa to control excessive bleeding following surgery for congenital heart disease in pediatric patients",
abstract = "The purpose of this article is to evaluate the efficacy of recombinant factor VII (rFVIIa) in the treatment of bleeding following cardiac surgery in a pediatric population. The study included a case series of postcardiac surgical patients with chest tube output of= 4 mL/kg/h for the initial 3 postoperative hours who received rFVIIa. Chest tube output for the 3 hours before and the 3 hours after rFVIIa was compared using a pairedt test. In addition, chest tube output for the initial 3 postoperative hours and the 3 hours following rFVIIa was compared to 8 control patients who did not require rFVIIa. Recombinant factor VIIa was administered to 9 children (age = 9 ± 4 years) following repair of tetralogy of Fallot (6), closure of ventricular septal defect (1), closure of sinus venosus atrial septal defect (1), and mitral valve repair (1). Chest tube output for the initial 3 postoperative hours prior to the administration of rFVIIa was 5.8 ± 2.8 mL/kg/h and decreased to 2.0 ± 1.3 mL/kg/h for the 3 hours following the administration of rFVIIa (P=.002). In the patients that did not receive rFVIIa, chest tube output for the first 3 postoperative hours was 1.6 ± 0.9 mL/kg/h and 1.2 ± 0.6 mL/kg/h for the next 3 hours (P= nonsignificant when compared to chest tube output for the 3 hours following rFVIIa in patients who received rFVIIa). No adverse effects were noted. Recombinant factor VIIa decreased chest tubing bleeding following cardiac surgery in children. Given its potential therapeutic impact, rFVIIa warrants further investigation in the pediatric cardiac population.",
keywords = "Chest tubing bleeding, Congenital heart disease, Pediatric cardiac patients, Recombinant factor VIIa",
author = "Tobias, {Joseph D.} and Simsic, {Janet M.} and Samuel Weinstein and William Schechter and Vyas Kartha and Michler, {Robert E.}",
year = "2004",
month = "9",
doi = "10.1177/0885066604267783",
language = "English (US)",
volume = "19",
pages = "270--273",
journal = "Journal of Intensive Care Medicine",
issn = "0885-0666",
publisher = "SAGE Publications Inc.",
number = "5",

}

TY - JOUR

T1 - Recombinant factor VIIa to control excessive bleeding following surgery for congenital heart disease in pediatric patients

AU - Tobias, Joseph D.

AU - Simsic, Janet M.

AU - Weinstein, Samuel

AU - Schechter, William

AU - Kartha, Vyas

AU - Michler, Robert E.

PY - 2004/9

Y1 - 2004/9

N2 - The purpose of this article is to evaluate the efficacy of recombinant factor VII (rFVIIa) in the treatment of bleeding following cardiac surgery in a pediatric population. The study included a case series of postcardiac surgical patients with chest tube output of= 4 mL/kg/h for the initial 3 postoperative hours who received rFVIIa. Chest tube output for the 3 hours before and the 3 hours after rFVIIa was compared using a pairedt test. In addition, chest tube output for the initial 3 postoperative hours and the 3 hours following rFVIIa was compared to 8 control patients who did not require rFVIIa. Recombinant factor VIIa was administered to 9 children (age = 9 ± 4 years) following repair of tetralogy of Fallot (6), closure of ventricular septal defect (1), closure of sinus venosus atrial septal defect (1), and mitral valve repair (1). Chest tube output for the initial 3 postoperative hours prior to the administration of rFVIIa was 5.8 ± 2.8 mL/kg/h and decreased to 2.0 ± 1.3 mL/kg/h for the 3 hours following the administration of rFVIIa (P=.002). In the patients that did not receive rFVIIa, chest tube output for the first 3 postoperative hours was 1.6 ± 0.9 mL/kg/h and 1.2 ± 0.6 mL/kg/h for the next 3 hours (P= nonsignificant when compared to chest tube output for the 3 hours following rFVIIa in patients who received rFVIIa). No adverse effects were noted. Recombinant factor VIIa decreased chest tubing bleeding following cardiac surgery in children. Given its potential therapeutic impact, rFVIIa warrants further investigation in the pediatric cardiac population.

AB - The purpose of this article is to evaluate the efficacy of recombinant factor VII (rFVIIa) in the treatment of bleeding following cardiac surgery in a pediatric population. The study included a case series of postcardiac surgical patients with chest tube output of= 4 mL/kg/h for the initial 3 postoperative hours who received rFVIIa. Chest tube output for the 3 hours before and the 3 hours after rFVIIa was compared using a pairedt test. In addition, chest tube output for the initial 3 postoperative hours and the 3 hours following rFVIIa was compared to 8 control patients who did not require rFVIIa. Recombinant factor VIIa was administered to 9 children (age = 9 ± 4 years) following repair of tetralogy of Fallot (6), closure of ventricular septal defect (1), closure of sinus venosus atrial septal defect (1), and mitral valve repair (1). Chest tube output for the initial 3 postoperative hours prior to the administration of rFVIIa was 5.8 ± 2.8 mL/kg/h and decreased to 2.0 ± 1.3 mL/kg/h for the 3 hours following the administration of rFVIIa (P=.002). In the patients that did not receive rFVIIa, chest tube output for the first 3 postoperative hours was 1.6 ± 0.9 mL/kg/h and 1.2 ± 0.6 mL/kg/h for the next 3 hours (P= nonsignificant when compared to chest tube output for the 3 hours following rFVIIa in patients who received rFVIIa). No adverse effects were noted. Recombinant factor VIIa decreased chest tubing bleeding following cardiac surgery in children. Given its potential therapeutic impact, rFVIIa warrants further investigation in the pediatric cardiac population.

KW - Chest tubing bleeding

KW - Congenital heart disease

KW - Pediatric cardiac patients

KW - Recombinant factor VIIa

UR - http://www.scopus.com/inward/record.url?scp=16544374365&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=16544374365&partnerID=8YFLogxK

U2 - 10.1177/0885066604267783

DO - 10.1177/0885066604267783

M3 - Article

VL - 19

SP - 270

EP - 273

JO - Journal of Intensive Care Medicine

JF - Journal of Intensive Care Medicine

SN - 0885-0666

IS - 5

ER -