Recombinant Activated Factor VIIa (rFVIIa) Treatment in Very-Low-Birth-Weight (VLBW) Premature Infants with Acute Pulmonary Hemorrhage: A Single-Center, Retrospective Study

Cosar, Hese; Işik, Halil; Çakır, Salih Çağrı; Yar, Nese; Goksen, Bulent; Tokbay, Hakan; Kertmen, Hasan; Erdoğan, Nihal; Durak, İkbal

doi:10.1007/s40272-016-0203-3

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…The survival group had more patients received plasma treatment, but multivariate logistic regression showed that plasma treatment did not increase survival. In the meantime, recent studies have also presented similar strategies, such as the using haemocoagulase or recombinant factor VII, as potential therapy for PH (18,19). By contrast, Usemann et al (20) found that infusion of FFP (10-20 mL/kg) within 4 hours increased the risk of pulmonary hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Exploring prediction model and survival strategies for pulmonary hemorrhage in premature infants: a single-center, retrospective study

Li¹,

Xia²,

Ye³

et al. 2021

Transl Pediatr

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Background: Pulmonary hemorrhage is a potentially fatal event especially for preterm infants, which can lead to serious complications and even death. Many risk factors have been associated with the development of massive pulmonary hemorrhage. However, there is still no effective strategy to prevent massive pulmonary hemorrhage. The purpose of this study is to explore prediction model and survival strategies for massive pulmonary hemorrhage in premature infants.Methods: In this retrospective study, we included all premature infants with birth weight <1,500 g who were hospitalized in our neonatal intensive care unit (NICU) between January 01 2010 and December 31 2019.Results: Of 599 preterm infants, 51 developed massive pulmonary hemorrhage. The logistic regression analysis showed that patent ductus arteriosus [odds ratio (OR) =11.4, 95% confidence interval (CI): 4.79-27.0, P<0.0001], coagulopathy (OR =6.56, 95% CI: 2.83-15.2, P<0.0001), and 10-minute Apgar Score (OR =0.52, 95% CI: 0.37-0.73, P=0.0001) were risk factors for massive pulmonary hemorrhage. Whether or not surfactant is used, the positive predictive value of combined patent ductus arteriosus and coagulopathy for predicting massive pulmonary hemorrhage was 68.9% and 70.4%, respectively. Of the 51 preterm infants with massive pulmonary hemorrhage, 25 died and 26 survived. The survivors group had higher positive endexpiratory pressure compared with the deceased group after the onset of massive pulmonary hemorrhage.After adjusting for potential risk factors, the multiple logistic regression analysis showed that higher positive end-expiratory pressure levels are closely related to survival.Conclusions: Patent ductus arteriosus combined with coagulopathy has a high predictive value for massive pulmonary hemorrhage. Higher positive end-expiratory pressure levels may reduce mortality in massive pulmonary hemorrhage.

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Section: Discussionmentioning

confidence: 99%

Exploring prediction model and survival strategies for pulmonary hemorrhage in premature infants: a single-center, retrospective study

Li¹,

Xia²,

Ye³

et al. 2021

Transl Pediatr

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“…In contrast to our data, the authors gave only one dose of aFVII and the clinical situation was complicated by circulatory failure secondary to the pulmonary hemorrhage. In the second [4], the authors found positive effects of aFVII on pulmonary bleeding but no effects on IVH. Thus, the success of aFVII treatment in progressing IVH may be essentially dependent on optimal timing, duration and dosing of treatment, as we discuss below.…”

Section: Discussionmentioning

confidence: 97%

IVH in VLBW Preterm Babies – Therapy with Recombinant Activated F VII?

et al. 2017

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Intraventricular hemorrhage (IVH) remains a dangerous and frequent complication in very low birth weight (VLBW) infants. Activated factor VII (aFVII) activates the coagulation cascade and is a potential tool for stopping active bleeding, including limiting the extent of an IVH. This retrospective treatment observation compared data for infants with IVH progression treated with fresh frozen plasma (FFP) alone or with a combination of FFP and aFVII. All infants were subject to cranial ultrasonography at least twice daily. When an IVH was detected, treatment with FFP (5-20 ml/kg every 4-6 h) was commenced and the parents were informed. If the parents endorsed aFVII treatment and the IVH showed progress, aFVII (30-50 µg/kg body weight 4-6 times within 16-24 h) was given. Otherwise, infants were treated with FFP only. We compared the course of IVH between the aFVII+FFP treated infants and a control group (FFP only). 35 patients throughout were included in the analysis (17 control and 18 aFVII group). Demographic data was not different between groups. The progress of IVH was significantly less in the aFVII group (p<0.01). During the hospital stay, 2 of the infants in the aFVII group died compared to 4 in the control group. A posthemorrhagic hydrocephalus developed in 3 aFVII and 6 control infants. All other outcome parameters and follow-up-results 2 years after treatment did not differ significantly. These data show that in the case of a progressing IVH, aFVII may be a candidate for limiting its extent. A prospective randomized trial is warranted.

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Pulmonary Hemorrhage in the Neonate

Welde¹,

Sanford²,

Mangum³

et al. 2021

Neonatal Network

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Pulmonary hemorrhage (PH) is a pathology associated with significant morbidity and mortality, particularly among preterm infants in the NICU. The diagnosis is made when hemorrhagic secretions are aspirated from the trachea concurrent with respiratory decompensation that necessitates intubation or escalated support. The implementation of mechanical ventilation and widespread exogenous surfactant administration have significantly reduced respiratory morbidities. However, when PH develops, death remains the most common outcome. Treatment for PH remains primarily supportive; thus, a thorough understanding of underlying disease processes, manifestations, diagnostic testing, and current evidence is vital to enable early identification and proactive management to reduce morbidity and mortality.

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Recombinant Activated Factor VIIa (rFVIIa) Treatment in Very-Low-Birth-Weight (VLBW) Premature Infants with Acute Pulmonary Hemorrhage: A Single-Center, Retrospective Study

Cited by 3 publications

References 24 publications

Exploring prediction model and survival strategies for pulmonary hemorrhage in premature infants: a single-center, retrospective study

Exploring prediction model and survival strategies for pulmonary hemorrhage in premature infants: a single-center, retrospective study

IVH in VLBW Preterm Babies – Therapy with Recombinant Activated F VII?

Pulmonary Hemorrhage in the Neonate

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