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首页> 外文期刊>Anaesthesia and intensive care >The use of recombinant activated factor VII for refractory bleeding post complex cardiothoracic surgery.
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The use of recombinant activated factor VII for refractory bleeding post complex cardiothoracic surgery.

机译：重组激活因子VII在复杂心胸外科手术后难治性出血中的应用。

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We reviewed the outcome following use of recombinant activated factor VII (rVIIa) in patients with major bleeding post cardiothoracic surgery in our unit between January 2002 and July 2004. The unit consists of 16 cardiothoracic intensive care beds in a public metropolitan teaching hospital which serves as a referral centre for heart and lung transplant surgery. Patients with refractory bleeding following cardiothoracic surgical procedures who were treated with rVIIa were identified. A total of 12 episodes of rVIIa use were recorded in ten patients, including three episodes with ventricular assist devices, and 5 heart and/or lung transplants. The median dose used was 85 microg/kg. Chest tube drainage decreased in all patients following administration of rVlIIa; median chest tube drainage decreased from 445 ml/h to 171 ml/h (P = 0.03). Despite cessation of bleeding, mortality was high when rVIIa was used after more than 24 hours. In six episodes, despite early rVIIa use (within six hours), continued bleeding necessitated return to theatre, where a surgical source of bleeding was found. In this small retrospective study, rVIIa significantly reduced bleeding that was refractory to standard blood product transfusion. In this series of patients, those that did not respond to rVIIa early in the postoperative phase were found to have a surgical source of bleeding.
机译：我们回顾了2002年1月至2004年7月在我们单位心胸外科手术后发生大出血的患者中使用重组活化因子VII（rVIIa）后的结局。该单位由16家心胸重症监护病床组成，该床位设在公立大都会教学医院，心脏和肺移植手术的转诊中心。确定了经心胸外科手术治疗后难治性出血的患者用rVIIa治疗。在10名患者中记录了总共12次使用rVIIa的事件，包括3次使用心室辅助装置的事件以及5次心脏和/或肺移植的事件。使用的中位剂量为85微克/千克。服用rVlIIa后所有患者的胸管引流均减少;中位胸管引流从445 ml / h降至171 ml / h（P = 0.03）。尽管停止了出血，但超过24小时使用rVIIa时，死亡率仍然很高。在六次发作中，尽管早期使用了rVIIa（六个小时之内），但持续的出血仍需要回到剧院，那里发现了手术出血的来源。在这项小型回顾性研究中，rVIIa显着减少了标准血制品输注难治的出血。在这一系列患者中，在术后早期对rVIIa无反应的患者被发现具有手术出血源。

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