Fritsch N, Pouquet O, Roux B, Abdelmoumen Y, Janvier G
Service de réanimation de chirurgie cardiaque, hôpital du Haut-Lévèque, CHU de Bordeaux, 1, avenue de Magellan, 33600 Pessac, France.
Ann Fr Anesth Reanim. 2010 Jan;29(1):45-7. doi: 10.1016/j.annfar.2009.10.017. Epub 2010 Jan 18.
Massive bleeding is a dreaded complication of biventricular mechanical assistance implantation. Its origin is multifactorial. Blood products transfusion associated with correction of coagulopathy are sometimes insufficient. We report two cases of massive bleeding after a Thoratec biventricular assistance implantation. After surgical haemostasis failure and despite the correction of coagulation disorders, a major bleeding persisted, so these patients received a single injection of 90 microg/kg of rFVIIa. This allowed in both cases a significant reduction of the bleeding and the restoration of normal haemodynamic conditions. This treatment was not complicated by any thrombotic accident.
大出血是双心室机械辅助植入术令人恐惧的并发症。其成因是多方面的。与凝血障碍纠正相关的血液制品输注有时并不充分。我们报告两例Thoratec双心室辅助植入术后大出血的病例。在手术止血失败且尽管凝血障碍已得到纠正的情况下，大出血仍持续存在，因此这些患者接受了单次90微克/千克的重组活化因子VIIa注射。这在两例病例中均使出血显著减少，并恢复了正常的血流动力学状态。该治疗未出现任何血栓形成意外的并发症。
