Johansson Pär I, Eriksen Kirsten, Alsbjørn Bjarme
Department of Clinical Immunology, University Hospital of Copenhagen, Copenhagen, Denmark.
J Trauma. 2006 Oct;61(4):1016-8. doi: 10.1097/01.ta.0000239261.48022.f1.
Major burn wound excision is associated with excessive perioperative blood loss. Treatment of massive microvascular bleeding represents a special problem in the burn setting, characterized by extensive damage at the capillary level, and resulting in a profound blood loss; which together with the consumptive states makes adequate replacement therapy with coagulation factors and platelets difficult. We described our experience with rescue treatment with rFVIIa in four patients undergoing major wound excision, developing life-threatening perioperative bleeding, and not responding to conventional therapy. Hemostasis was achieved within 15 minutes of intravenous rFVIIa administration, at a dose of 100 microg/kg, in all patients. No treatment-related adverse events, in particular, no thromboembolic events were observed. We conclude that rFVIIa may be an effective hemostatic treatment for patients undergoing major wound excision developing life-threatening bleedings.
大面积烧伤创面切除与围手术期失血过多有关。在烧伤情况下，大量微血管出血的治疗是一个特殊问题，其特点是毛细血管水平广泛受损，导致大量失血；这与消耗性状态一起，使得用凝血因子和血小板进行充分的替代治疗变得困难。我们描述了我们对4例接受大面积创面切除、发生危及生命的围手术期出血且对传统治疗无反应的患者使用重组活化凝血因子VII（rFVIIa）进行抢救治疗的经验。所有患者在静脉注射剂量为100微克/千克的rFVIIa后15分钟内实现止血。未观察到与治疗相关的不良事件，特别是未观察到血栓栓塞事件。我们得出结论，rFVIIa可能是对接受大面积创面切除并发生危及生命出血的患者有效的止血治疗方法。
