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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2007

Open Access 01-12-2007 | Case report

Failure of recombinant factor VIIa in a patient with severe polymicrobial sepsis and postoperative uncontrolled intraabdominal bleeding

Authors: Anna Conen, Maja Weisser, Dimitrios A Tsakiris, Martin Siegemund

Published in: BMC Infectious Diseases | Issue 1/2007

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Abstract

Background

This report discusses a case of unsuccessful treatment with recombinant factor VIIa (rFVIIa) in off-label use. The need for international guidelines concerning the off-label use of rFVIIa is outlined as well as the need for methods to control the efficacy of rFVIIa objectively.

Case presentation

54 year old male with severe polymicrobial sepsis due to a perforated diverticulitis of the sigmoid colon and consecutive overt disseminated intravascular coagulation. He suffered severe intraabdominal bleeding after abdominal surgery despite conventional haemostatic support. Repeated applications of factor VIIa temporarily improved coagulation essays but did not stop clinical bleeding. The patient died in multiorgan failure due to septic and haemorrhagic shock.

Conclusion

Off-label use of rFVIIa could result in more side effects than could be expected from literature because of a publication bias. However for most off-label applications large prospective, randomised and controlled trials to confirm the positive findings are missing. For the future, not only guidelines concerning the off-label use of rFVIIa are urgently needed but also guidelines for monitoring the efficacy of rFVIIa.
Appendix
Available only for authorised users
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Metadata
Title
Failure of recombinant factor VIIa in a patient with severe polymicrobial sepsis and postoperative uncontrolled intraabdominal bleeding
Authors
Anna Conen
Maja Weisser
Dimitrios A Tsakiris
Martin Siegemund
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2007
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-7-34

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