Uhrig Lynn, Blanot Stéphane, Baugnon Thomas, Orliaguet Gilles, Carli Pierre A, Meyer Philippe G
Pediatric Anesthesiology and Neuro Critical Care Unit, Faculté de Médecine René Descartes, Centre Hospitalier Universitaire Necker- Enfants Malades, Paris, France.
Pediatr Crit Care Med. 2007 Nov;8(6):576-9.
To report the use of recombinant activated factor VII (NovoSeven; Novo Nordisk A/S, Bagsvaerd, Denmark) in children undergoing major neurosurgical procedures and experiencing massive uncontrolled hemorrhagic shock.
Retrospective review of patients and analysis of clinical and biological effects of an intravenous administration of recombinant activated factor VII.
Neurosurgical anesthesia and critical care unit of a pediatric university hospital.
PATIENTS/SUBJECTS: Four children, <12-kg body weight, experiencing life-threatening perioperative hemorrhage required conventional treatment (massive red blood cells, fresh frozen plasma, platelet transfusion, and surgical hemostatic maneuvers) that failed to obtain definite hemostasis.
Intravenous administration of recombinant activated factor VII (100 microg/kg).
Intravenous administration resulted in a significant decrease in blood loss within minutes (preventing further need of transfusion), normalization of biological hemostasis markers, and improved surgical hemostasis. No side effects of recombinant activated factor VII were noted, and all patients, except one, had a good recovery.
These four patients support the use of recombinant activated factor VII as a useful adjunct to control massive life-threatening bleeding during pediatric neurosurgical procedures when other means failed. However, the data are still limited in children, and more extensive research is needed to define the indications of recombinant activated factor VII in massive surgical hemorrhage in low-weight children.
报告重组活化凝血因子 VII（诺其；丹麦诺和诺德公司， Bagsvaerd）在接受重大神经外科手术且发生大量难以控制的出血性休克的儿童中的应用情况。
对患者进行回顾性研究，并分析静脉注射重组活化凝血因子 VII 的临床和生物学效应。
一家儿科大学医院的神经外科麻醉和重症监护病房。
患者/受试者：4 名体重<12 千克的儿童，在围手术期发生危及生命的出血，需要常规治疗（大量输注红细胞、新鲜冰冻血浆、血小板输注及手术止血措施），但未能实现确切止血。
静脉注射重组活化凝血因子 VII（100 微克/千克）。
静脉注射后数分钟内失血量显著减少（避免了进一步输血的需求），生物学止血指标恢复正常，手术止血得到改善。未观察到重组活化凝血因子 VII 的副作用，除 1 名患者外，所有患者恢复良好。
这 4 例患者支持在其他方法无效时，使用重组活化凝血因子 VII 作为控制儿童神经外科手术期间大量危及生命出血的有效辅助手段。然而，儿童的数据仍然有限，需要更广泛的研究来确定重组活化凝血因子 VII 在低体重儿童大量手术出血中的应用指征。
