The Effect of Recombinant Factor VIIa and Fibrinogen on Bleeding from Grade V Liver Injuries in Coagulopathic Swine
Abstract
Recombinant factor Vlla (rFVlla) has been used to decrease bleeding in a number of settings including hemophilia, liver transplantation, intractable bleeding and cirrhosis. This study was performed to determine if rFVlla would reduce bleeding after a grade V liver injury in hypothermic, dilutionally coagulopatnic pigs when used as an adjunct to abdominal packing and to determine the optimal dose of the drug. Methods: Thirty animals were randomized to receive 180 mug1kg of rFVlla, 720 mug1kg of rFVlla or control. After laparotomy and splenectomy animals underwent a 60% of blood volume isovolemic exchange transfusion with 5% human albumin. The animals' temperature was maintained at 330C and a grade V liver injury was made with a clamp. Thirty seconds after injury the abdomen was packed with laparotomy sponges, resuscitation was initiated and blinded therapy was given. Animals were resuscitated to their baseline mean arterial pressure (MAP) and the study was continued for 2 hours. Serial coagulation parameters were measured at the temperature they were drawn. Following the study period, surviving animals were euthanized, post-treatment blood loss was measured and an autopsy was performed. Results: Ten animals were randomized to each group. Following administration of study drug, the mean prothrombin time (PT) was shorter in the treatment groups than in the control group. MAP was lower in the control group than the treatment groups throughout the study, (p<O.O1). Mean blood loss was significantly less in the treatment groups than the control group. Mortality was not different between groups. There were no differences between the groups that received rFVlla in any measured parameters. Conclusions: rFVlla reduces blood loss in hypothermic, dilutionally coagulopathic pigs with grade V injuries when used as an adjunct to packing. Increasing the dose does not enhance the hemostatic effect.
Document Details
- Document Type
- Technical Report
- Publication Date
- Sep 01, 2002
- Accession Number
- ADA408711
Entities
People
- David J Tweardy
- Joe M. Macaitis
- John B Holcomb
- Martin A. Schreiber
- Susan I. Brundage
Organizations
- Baylor College of Medicine