scholarly journals Use of low dose of rFVIIa (recombinant Factor VII activated) to control late bleeding after percutaneous dilational tracheostomy

2019 ◽  
Vol 7 (4) ◽  
pp. 665-667
Author(s):  
Dario Nicosia ◽  
Antonino Federico ◽  
Ivan Vigna ◽  
Pasquale Iozzo ◽  
Giovanni Misseri ◽  
...  
1987 ◽  
Author(s):  
S J Machin ◽  
I J Mackie ◽  
K Walshe ◽  
M D Gillmer

The haemostatic system was investigated in 26 women taking cyclically administered triphasic combined oral contraceptives for the first time during their first six cycles. Fourteen women received Logynon (mean dose 32.4μg ethinyloestradiol, 92pg progestagen) and 12 received SHD 415G (Schering) which contains a mean dosage of 32.4μg ethinyloestradiol and 78pg gestodene, a recently developed progesterone. The Logynon group showed a significant increase (p<0.005) in fibrinogen (pre-mean 284.4 g/1; after 1 cycle 347.3 g/1, after 6 cycles 318.6 g/1) , factor VII (65.8 u/1 to 73.9 u/1 to 83.2 u/1), factor XII (1.74 u/1 to 2.41 u/1, to 2.25 u/1), plasminogen (100.9 u/1 to 135.1 u/1 to 126.3 u/1); decrease in ATIII (115.9 u/1 to 103.1 u/1 to 93.4 u/1) but no significant change in factor X (98.4 u/1 to 108.9 u/1 to 102.4) or protein C (0.85 u/1 to 0.88 u/1 to 0.94 u/1) activity. The SHD 415G group showed similar changes with an increase in fibrinogen (247.9 g/1 to 330.8 g/1 to 373 .1 g/1), factor VII (63.1 u/1 to 73.1 u/1 to 90.3 u/1, factor X (98.3 u/1 to 112.0 u/1 to 124.4 u/1), factor XII (1.46 u/1, to 1.93 u/1, to 2.03 u/1), plasminogen (110.8 u/1 to 125.4 u/1 to 136.7 u/1); decrease in ATIII (113.1 u/1 to 96.3 u/1 to 89.7 u/1), but no change in protein C (0.84 u/1 to - 0.78 u/1 to 0.85 u/1) activity. These changes were apparent after the first cycle of therapy and the differences were maintained over the six cycle period. There was no increase in protein C activity despite changes in the other vitamin K dependent proteins factors VII and X. Both low oestrogen dose triphasic pills caused similar prothrombotic changes which were not modified by the new progesterone, gestodene.


2011 ◽  
Vol 28 ◽  
pp. 87
Author(s):  
Ledesma M. Ontañón ◽  
Rabasa A. Romera ◽  
Saiz E. Barrio ◽  
Iglesias M. de la Vega ◽  
Villamandos B. Quintana ◽  
...  

1996 ◽  
Vol 10 (sup2) ◽  
pp. 145-148 ◽  
Author(s):  
K. W. M. Bloemenkamp ◽  
J. A. Gevers Leuven ◽  
F. M. Helmerhorst ◽  
M. C. Dersjant-Roorda ◽  
R. de Boer ◽  
...  

Blood ◽  
1995 ◽  
Vol 85 (11) ◽  
pp. 3034-3039 ◽  
Author(s):  
GE Raskob ◽  
SS Durica ◽  
JH Morrissey ◽  
WL Owen ◽  
PC Comp

Factor VII is an independent risk factor for ischemic heart disease. We performed a prospective study to evaluate the effect of combined low-dose warfarin-aspirin on activated factor VII (factor VIIa) and to determine if abruptly stopping this treatment is associated with a rebound in the level of factor VIIa. Thirty-three patients with clinically stable coronary artery disease were treated with combined 3 mg warfarin and 80 mg aspirin daily for 8 weeks. The factor VIIa level was measured before treatment, weekly during treatment, and 2 weeks after stopping treatment. The mean percent of pretreatment levels of factor VIIa for weeks 1 through 8 of treatment were 60%, 60%, 72%, 70%, 71%, 70%, 74%, and 87%, respectively (P < .05 compared with pretreatment for weeks 1 through 7 inclusive); 2 weeks after stopping treatment, the level was 122% (95% confidence interval [CI]; 111% to 133%; P < .001 compared with pretreatment). The mean percent level of factor VIIa on-treatment was 74% (P < .001). Factor VIIa is reduced by 26% on average during treatment. This finding provides further rationale for the antithrombotic effect of low-dose warfarin. The results suggest a rebound in the factor VIIa level may occur after treatment is stopped. The potential rebound and its clinical importance should be evaluated by further studies.


1999 ◽  
Vol 82 (09) ◽  
pp. 1112-1116 ◽  
Author(s):  
Anne-Marie Vissac ◽  
Jean-Michel Kirzin ◽  
Pierre Bourgeat ◽  
Jean Amiral ◽  
Rachid Agher ◽  
...  

SummaryAmong users of low-dose oral contraceptives (OC), cardiovascular diseases occur mainly in smokers. The mechanisms by which OC and smoking increase the risk for arterial thrombotic risk have not been adequately explained. Epidemiological evidence suggests that changes in blood coagulation and fibrinolysis may play an important role as determinants of thrombotic events. Therefore, we have investigated the associations of OC and smoking with haemostatic variables among 194 premenopausal healthy women. Fourty women were current users of low-dose OC and 62 women were smokers. After adjustment for age and body mass index, mean values of factor XIIa, factor VII activity and antigen, fibrinogen, D-dimer, global fibrinolytic capacity were significantly higher in OC users than in non-users. Mean levels of PAI activity and t-PA antigen were significantly lower in OC users than in non-users. Smokers had significantly higher mean values of fibrinogen than non-smokers. Two-way analysis of variance showed that the differences in mean levels of fibrinogen and D-dimer between OC users and non users were restricted to smokers. The positive and significant interactions between OC use and smoking in their effects on haemostatic variables were consistent with respect to age and type of OC. These preliminary data suggest that elevated plasma levels of fibrinogen and intravascular fibrin deposition may play a role in the pathogenesis of arterial thrombotic disease among women who are both low-dose OC users and smokers.


2015 ◽  
Vol 5 (1) ◽  
pp. 26-31
Author(s):  
Sheila Sarial ◽  
Rozhan Sonboli ◽  
Shayan Maleknia ◽  
Fatemeh Ashori ◽  
Sara Rezaeiravesh ◽  
...  

Recombinant human factor VII (rh-FVII) is produced by engineered BHK cells at low dose. Accordingly, establishment of a precise method is crucial to reliably measuring expression level of this protein during manufacturing pro-cesses. We developed and established a reproducible sandwich enzyme-linked immunosorbent assay (ELISA) method for measuring amount of FVII during biopharmaceutical in upstream and downstream processes of Aryo-Seven. A sandwich ELISA was designed using two different high affinity mon-oclonal antibodies (mAb1 and mAb2) against h-FVII. The bounded FVII to the first antibody was revealed by the use of a second mouse anti-FVII monoclo-nal antibody (1F1-B11), labeled with HRP that binds to another antigenic determinant of the FVII. Then, validation was done by determination of spec-ificity, linearity, accuracy, precision, reproducibility, detection and quantifica-tion limit and robustness according to ICH Q2 (R1) guideline. In developed ELISA, no interference was found between FVII and proteins derived from BHK which commonly exist in the supernatant. Linear range of detection was from 25-1.56 ng/mL with P-Value <0.001. In accuracy, spiked samples showed 109±2% recovery. Intra and intermediate precision assays showed %RSD not more than20. Detection limit of this assay was 0.99 ng /mL and limit of quantification was 2.99 ng/ml. The sandwich ELISA was found to be useful tool for measuring FVII/ FVIIa. The ELISA approach was precise, repro-ducible, and accurate. The ELISA therefore, is offered as an assured kit for detection of recombinant human factor.


2009 ◽  
Vol 102 (09) ◽  
pp. 487-492 ◽  
Author(s):  
Tami Livnat ◽  
Ilia Tamarin ◽  
Yoram Mor ◽  
Harry Winckler ◽  
Zeev Horowitz ◽  
...  

SummaryOne-third of patients with severe factor XI (FXI) deficiency caused by homozygosity for null alleles develop inhibitor antibodies following exposure to plasma. Haemostasis during surgery is achievable in such patients by recombinant activated factor VII (rFVIIa) at doses used in haemophilia A patients with an inhibitor to FVIII. However, thrombosis has occurred in three of 12 such patients. In this study we discerned whether low-dose rFVIIa would secure haemostasis and cause no thrombosis in patients with severe FXI deficiency and an inhibitor during surgery. In vitro, a very low concentration of rFVIIa (0.24 µg/ml) induced thrombin generation in FXI-deficient plasma quite similarly to 1.9 µg/ml (a concentration that is achieved in patients with haemophilia A and inhibitor after infusion of 80 µg/kg). Based on this finding, a protocol was designed for four patients with severe FXI deficiency and an inhibitor or immunoglobulin A deficiency who underwent five major surgical procedures. This included administration of tranexamic acid from two hours before surgery until seven to 14 days after, and single infusion of low-dose rFVIIa. No excessive bleeding or thrombosis were observed. In conclusion, a single low dose of rFVIIa and tranexamic acid secure normal haemostasis in patients with severe FXI deficiency who can not receive blood products.


1987 ◽  
Author(s):  
C CARON ◽  
J P JOUET ◽  
J HIMPENS ◽  
P HIVES ◽  
H GRUSON ◽  
...  

Decrease of factor VII (F VII) and protein C (PC) has been said to allow an early detection of hepatic veno-occlusive disease (VOD) (VILMER, Path. Biol. 1986, 34 : 79), that represents a serious complication of bone marrow transplantation (BMT). In this purpose, F VII (activity) and PC (antigen) have been measured in 18 patients (aged 9 to 45 yr- m : 26 yr) who underwent allogeneic bone marrow graft for chronic myelogenous leukemia (9 cases), acute lymphocytic leukemia (7 cases) acute myelogenous leukemia (2 cases). All patients received as preparation for BMT total body irradiation (mean dose = 10 Gy) along with cyclophosphamide (120 mg/Kg). All were given low dose heparin (100 UI/Kg/24 hr) from days -7 to +30. None of the patients developed VOD but graft-versus-host disease occurred in 13 out of them between days 18 and 52. Moreover, coagulation studies performed from days 1 to 28 detected a moderate decrease of F VII and PC (maximum on day 11). These parameters were normalized on day 28. The level of the other vitamin K-dependent factors was not significantly changed.So the moderate decrease of F VII and PC found in the post-graft period was not associated with hepatic VOD. However, as none of the patients developed this complication, these results do not exclude that a major decrease of these parameters could serve as an early diagnosis of VOD. On the other hand, a prophylactic effect of low dose heparin cannot be ruled out.


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