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Management of coagulopathy with recombinant factor VIIa in a neonate with echovirus type 7
Author(s) -
Tancabelic Jakica,
Haun Steven Edward
Publication year - 2004
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.20078
Subject(s) - medicine , recombinant factor viia , coagulopathy , cryoprecipitate , fresh frozen plasma , disseminated intravascular coagulation , sepsis , anesthesia , hemostasis , surgery , platelet
A 5‐day‐old newborn presented with neonatal enteroviral infection. The patient's hospital course was complicated by acute liver dysfunction, renal insufficiency, fluid overload, respiratory failure, hypertension, catheter related thrombosis, Klebsiella pneumoniae sepsis, intracerebral and intraventricular hemorrhage, and disseminated intravascular coagulation (DIC). Administration of fresh frozen plasma (FFP) and cryoprecipitate failed to control the patient's hemostasis and led to significant fluid overload. Recombinant activated factor VII (rFVIIa, Novoseven® NovoNordisk, Bagsvaerd, Denmark) was given to the neonate as a bolus (rFVIIa at 60–80 μg/kg body weight), followed by a continuous infusion (2.5–16 μg/kg/hr). Recombinant activated factor VII controlled hemostasis, until the patient's liver function recovered. The patient's blood product requirement significantly decreased and his fluid overload resolved. Administration of rFVIIa appears to have stabilized the coagulation process. The patient appears to have fully recovered from the infection's complications. © 2004 Wiley‐Liss, Inc.