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Recombinant activated factor VII and the anaesthetist
Author(s) -
Welsby I. J.,
Monroe D. M.,
Lawson J. H.,
Hoffmann M.
Publication year - 2005
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2005.04376.x
Subject(s) - medicine , recombinant dna , recombinant factor viia , glanzmann's thrombasthenia , intensive care medicine , factor viia , platelet , thrombasthenia , factor vii , refractory (planetary science) , intensive care unit , surgery , tissue factor , coagulation , astrobiology , gene , biochemistry , chemistry , physics , platelet aggregation
Summary Recombinant activated factor VII is a safe and effective for the treatment and prevention of haemorrhage in haemophiliacs with circulating inhibitors to replacement factors, and patients with Glanzmann's thrombasthenia refractory to platelet transfusion. By restoring thrombin generation on the surface of tissue factor bearing cells, such as activated platelets and monocytes, recombinant activated factor VII has the potential to effect haemostasis in the setting of many coagulopathic states encountered by the anaesthetist in the operating theatre or the intensive care unit. Case reports of successful rescue therapy make up the majority of the literature covering other, numerous, off‐label uses of recombinant activated factor VII, although some randomised, controlled studies, mostly underpowered to address safety concerns, have been performed. However, off‐label use is becoming increasingly popular judging by the number of published case reports. Additional randomised, controlled trials to determine the safe and appropriate use of this potentially valuable therapy in broader patient groups are eagerly awaited.