SESSION TITLE: Cardiovascular Disease Posters I
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM
PURPOSE: Hemorrhage is the most frequent complication occurring in patients who are on venoarterial or venovenous extracorporeal membrane oxygenation (ECMO). Recombinant activated factor VIIa (rFVIIa), a potent procoagulant has been used in these patients with conflicting results. We describe our experience in pediatric patients on ECMO who received rFVIIa for refractory bleeding.
METHODS: We reviewed the medical charts of all the patients who underwent ECMO in our PICU between January 1999 to July 2014 and received FVII for refractory bleeding. Clinical characteristics, demographics, type of congenital heart disease, surgical correction, bleeding, thrombotic complications, mortality, and rFVIIa dose were all documented.
RESULTS: 123 patients underwent ECMO in our unit since 1999, and five of them received rFVIIa for persistent refractory bleeding during venoarterial ECMO. All of these patients were postoperative cardiac surgery for congenital defects prior to the initiation of ECMO. Transfusion requirements dramatically decreased in 4 patients, without a major thrombotic event. In one patient bleeding remained significant and a left pulmonary artery thrombosus was confirmed by cardiac catheterisation. 4 patients survived at 48 hour after withdrawal from ECMO.
CONCLUSIONS: rFVIIa use for refractory bleeding in patients on ECMO was efficacious in stopping bleeding without major thrombotic events. While the use of rFVIIa seems effective, indications for its use, modalities of administration and precautions to be taken need to be better defined.
CLINICAL IMPLICATIONS: to outweight the benifices over the risks of using rFVIIa for patients on ECMO with severe refractory bleeding
DISCLOSURE: The following authors have nothing to disclose: Fahad Alsohime
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