Administration of Recombinant Activated Factor VII (NovoSeven) in Three Cases of Uncontrolled Bleeding Caused by Disseminated Intravascular Coagulopathy

Schmid, Stefan; Friesenecker, Barbara; Lorenz, Ingo; Innerhofer, Petra; Koscielny, Jürgen; Velik‐Salchner, Corinna; Mutz, N.; Fries, Dietmar

doi:10.1177/1076029607302567

Cited by 9 publications

(7 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Neutrophil elastase, which is released during sepsis, can degrade tissue factor pathway inhibitor, the inhibitor of the TF pathway, which may further enhance coagulation . Furthermore, case studies reported that FVII consumption and uncontrolled bleeding during sepsis can be reduced and survival improved by systemic administration of additional FVIIa . Occurrence of diffuse pulmonary bleeding can be reduced by local administration of FVIIa into the airspace of the lung…”

Section: Introductionmentioning

confidence: 99%

The coagulation system in host defense

Antoniak

2018

Research and Practice in Thrombosis and Haemostasis

153

109

View full text Add to dashboard Cite

The blood coagulation system and immune system of higher organisms are thought to have a common ancestral origin. During infections, the blood coagulation system is activated and components of the hemostatic system are directly involved in the immune response and immune system modulations. The current view is that the activation of coagulation is beneficial for infections with bacteria and viruses. It limits pathogen dissemination and supports pathogen killing and tissue repair. On the other hand, over‐activation can lead to thrombosis with subsequent depletion of hemostatic factors and secondary bleeding. This review will summarize the current knowledge on blood coagulation and pathogen infection with focus on most recent studies of the role of the different parts of the blood coagulation system in selected bacterial and viral infections.

show abstract

Section: Introductionmentioning

confidence: 99%

The coagulation system in host defense

Antoniak

2018

Research and Practice in Thrombosis and Haemostasis

153

109

View full text Add to dashboard Cite

show abstract

“…Treatment with rFVIIa (Eptacog alfa activated) may be helpful to alleviate severe bleeding in these patients. 104,105 Treatment with rFVIIa might be beneficial in patients with impaired platelet function, a possible side effect, potentially due to DIC-associated platelet exhaustion or treatment with various drugs, including nonsteroid anti-inflammatory drugs and antibiotics. Recombinant FVIIa has been shown to of interest in the management of obstetrical DIC secondary to placental abruption or amniotic fluid embolism and other conditions associated with severe peripartum hemorrhage.…”

Section: Therapeutic Strategies For Dicmentioning

confidence: 99%

Disseminated Intravascular Coagulation: An Update on Pathogenesis, Diagnosis, and Therapeutic Strategies

Papageorgiou

Jourdi

Adjambri

et al. 2018

Clin Appl Thromb Hemost

139

121

View full text Add to dashboard Cite

Disseminated intravascular coagulation (DIC) is an acquired clinicobiological syndrome characterized by widespread activation of coagulation leading to fibrin deposition in the vasculature, organ dysfunction, consumption of clotting factors and platelets, and life-threatening hemorrhage. Disseminated intravascular coagulation is provoked by several underlying disorders (sepsis, cancer, trauma, and pregnancy complicated with eclampsia or other calamities). Treatment of the underlying disease and elimination of the trigger mechanism are the cornerstone therapeutic approaches. Therapeutic strategies specific for DIC aim to control activation of blood coagulation and bleeding risk. The clinical trials using DIC as entry criterion are limited. Large randomized, phase III clinical trials have investigated the efficacy of antithrombin (AT), activated protein C (APC), tissue factor pathway inhibitor (TFPI), and thrombomodulin (TM) in patients with sepsis, but the diagnosis of DIC was not part of the inclusion criteria. Treatment with APC reduced 28-day mortality of patients with severe sepsis, including patients retrospectively assigned to a subgroup with sepsis-associated DIC. Treatment with APC did not have any positive effects in other patient groups. The APC treatment increased the bleeding risk in patients with sepsis, which led to the withdrawal of this drug from the market. Treatment with AT failed to reduce 28-day mortality in patients with severe sepsis, but a retrospective subgroup analysis suggested possible efficacy in patients with DIC. Clinical studies with recombinant TFPI or TM have been carried out showing promising results. The efficacy and safety of other anticoagulants (ie, unfractionated heparin, low-molecular-weight heparin) or transfusion of platelet concentrates or clotting factor concentrates have not been objectively assessed.

show abstract

“…72 However, in the clinical scenario of life-threatening hemorrhage (e.g., maternal postpartum hemorrhage complicated by DIC, neonatal necrotizing enterocolitis) the use of rFVIIa was described by others and us with varying success in achieving hemostasis. 22,[73][74][75] Our recommendation is to limit the use of rFVIIa to rescue attempts in scenarios of catastrophic acutely life-threatening hemorrhage in which conventional measures to achieve hemostasis have failed.…”

Section: Human Protein Cmentioning

confidence: 99%

Disseminated Intravascular Coagulation in Term and Preterm Neonates

Veldman

Fischer

Nold

et al. 2010

Semin Thromb Hemost

View full text Add to dashboard Cite

Among critically ill patients, the risk of developing disseminated intravascular coagulation (DIC) is probably highest in neonates. Low plasma reserves in pro- and anticoagulant coagulation factors, intravascular volume contraction after birth, and a high incidence of hypoxia and sepsis in critically ill newborns rapidly lead to a decompensation of the coagulation system in this population. Global coagulation tests and single-factor plasma levels have to be interpreted in the context of age-corrected normal ranges. Platelet consumption and reduced protein C plasma levels have diagnostic value; the latter also has prognostic potential in neonates with DIC and sepsis. Therapeutic success relies heavily on reversal of the underlying condition. Some coagulation-specific therapies have been explored in small studies and case series with varying success and sometimes conflicting results. Therefore, larger controlled trials in this common and serious condition are urgently needed.

show abstract

Administration of Recombinant Activated Factor VII (NovoSeven) in Three Cases of Uncontrolled Bleeding Caused by Disseminated Intravascular Coagulopathy

Cited by 9 publications

References 17 publications

The coagulation system in host defense

The coagulation system in host defense

Disseminated Intravascular Coagulation: An Update on Pathogenesis, Diagnosis, and Therapeutic Strategies

Disseminated Intravascular Coagulation in Term and Preterm Neonates

Contact Info

Product

Resources

About