Bleeding after cardiac surgery

C. von Heymann; C. Spies; H. Grubitzsch; H. Schönfeld; M. Sander; Th. Volk

doi:10.1055/s-0037-1617085

Hämostaseologie, Inhaltsverzeichnis

Hamostaseologie 2006; 26(S 02): S76-S86
DOI: 10.1055/s-0037-1617085

Original Article

Schattauer GmbH

Bleeding after cardiac surgery

The role of recombinant factor VIIa

Autoren

C. von Heymann

¹Department of Anaesthestics and Surgical Intensive Care, Charité – University Hospital Berlin, Campus Charité Mitte and Campus Virchow Klinikum
C. Spies

¹Department of Anaesthestics and Surgical Intensive Care, Charité – University Hospital Berlin, Campus Charité Mitte and Campus Virchow Klinikum
H. Grubitzsch

²Department of Cardiovascular Surgery, Campus Charité Mitte, Germany
H. Schönfeld

¹Department of Anaesthestics and Surgical Intensive Care, Charité – University Hospital Berlin, Campus Charité Mitte and Campus Virchow Klinikum
M. Sander

¹Department of Anaesthestics and Surgical Intensive Care, Charité – University Hospital Berlin, Campus Charité Mitte and Campus Virchow Klinikum
Th. Volk

¹Department of Anaesthestics and Surgical Intensive Care, Charité – University Hospital Berlin, Campus Charité Mitte and Campus Virchow Klinikum

Abstract

Summary

Cardiac surgery carries the risk of significant blood loss requiring the transfusion of blood products. In addition to such blood loss, international studies have shown that severe bleeding necessitating re-operation occurs in 3–5% of patients. Morbidity and mortality are significantly increased, so effective and safe haemostatic measures will decisively improve outcome of patients.

Recombinant activated factor VII (rFVIIa) has been approved for the treatment of patients with inhibitor haemophilia, as well as with Glanzmann’s thrombasthenia and factor VII deficiency. Many publications have appeared in the last few years which report the successful and reliable use of rFVIIa for the treatment of refractory bleeding after cardiac surgery. This review presents the pathophysiological changes in the coagulation system which occur when a heart-lung machine is used and which have been blamed for an increased risk of bleeding in patients who have undergone cardiac surgery. Published experience with rFVIIa in paediatric and adult cardiac surgery is presented and discussed critically with regard to the efficacy and safety of its use.

Keywords

Cardiac surgery - cardiopulmonary bypass - factor VIIa - rFVIIa - postoperative bleeding

Volltext

Referenzen

References
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