Use of Recombinant Activated Factor VII for Controlling Refractory Postoperative Bleeding in Children Undergoing Cardiac Surgery With Cardiopulmonary Bypass

Ex-vivo response to blood products and haemostatic agents after paediatric cardiac surgery

“…Retrospective studies have indicated that rVIIa is well tolerated and has a potential benefit in order to control bleeding after paediatric cardiac surgery [19][20][21]. The present study confirmed an effect of exvivo addition of rVIIa in children after cardiac surgery.…”

Off-Label Use of Recombinant Factor VIIa in Pediatric Patients

“…17 A recently published retrospective study of 90 pediatric patients who received rFVIIa for uncontrolled postoperative hemorrhage after cardiac surgery for congenital heart disease also demonstrated a reduction in blood loss and transfusion requirements after rFVIIa and found that reexploration for bleeding was avoided in ∼80% of cases. 24 All patients in this study underwent transthoracic echocardiogram and clinical examination, and no cases of thrombosis were detected.…”

Trends in Resource Utilization Associated with the Inpatient Treatment of Neonatal Congenital Heart Disease

“…A recent meta‐analysis of existing adult literature demonstrated no significant difference with respect to mortality and an increased risk for thromboembolic events . While some reports particular to pediatric cardiac surgery would suggest that use in refractory postoperative hemorrhage is associated with reductions in both blood loss and blood product requirements, others including a larger multicenter population describe a relatively high incidence of thrombosis (11%) with mortality rate of 34% among children with congenital heart disease . Economic analyses also yield conflicting results, though a recent report would suggest that activated Factor VII administration was in fact comparable with costs associated with reoperation for refractory postoperative hemorrhage in adult cardiac surgical patients .…”