The use of recombinant activated factor VII in the treatment of postoperative bleedings in children with congenital heart defects


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Abstract

The early postoperative period of patients after the correction of congenital heart defects under cardiopulmonary bypass is accompanied by an Increased risk of Needing. There is evidence of the effectiveness of recomNnant activated factor VII (rFVIIa) in the treatment of massive perioperative Needing In children with congenital heart defects. The aim of the retrospective study was to study the experience of using rFVIIa In the treatment of hypocoagulant postoperative bleeding In children with congenital heart defects. Materials and methods The analysis of the results of diagnostics and surgical treatment of 34 children aged 1 day to 17.5 years for congenital heart defects was carried out. The data of clinical observation and laboratory research were used. The Introduction of rFVIIa was performed in the presence of severe postoperative bleeding with a Nood loss rate of more than 3 ml/kg/h and signs of hypocoagulatlon. Results. In all patients, postoperative bleeding was stopped. In all age groups, except for the age of 3-7years, a significant decrease In the volume of bleeding was obtained with the relative time pdnt of rFVIIa administration. Complications and deaths were not observed. Conclusions The use of the rFVIIa preparation Is effective in the treatment of hypocoagulant postoperative Needing In children with congenital heart defects after corrective Interventions under cardiopulmonary bypass. There were no complications and side effects of the drug, which Indicates the safety of therapy.

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About the authors

A. A Kostromin

Children’s Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan

Email: kosart@rambler.ru

D. Yu Petrushenko

Children’s Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan

I. N Nurmeev

Children’s Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan; Kazan State Medical University of the Ministry of Health of Russia

Е. K Zainetdinovа

Children’s Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan

L. R Valiullin

Children’s Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan

L. Kh Galieva

Children’s Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan

L. V Malgina

Children’s Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan

References

  1. Самсонова Н.Н., Климович Л.Г., Ярустовский М.Б. и др. Диагностика и коррекция тромбогеморрагических осложнений у кардиохирургических больных в раннем послеоперационном периоде. Анестезиология и реаниматология. 2010; 5: 56-9 @@Samsonova N.N., Klimovich L.G., Yarustovsky М.В. et al. Diagnostics and correction of thrombohemorrhagic complications in cardiac surgery patients in the early postoperative period. Anesthesiology and resuscitation. 2010; 5: 56-9 (in Russ.).
  2. Wotf M.J., Maher K.O., Kanter K.R. et al. Early postoperative bleeding is independently associated with increased surgical mortality in infant after cardiopulmonary bypass. J Thorac Cardlovasc Surg. 2014; 148 (2): 631-6. doi: 10.1016/j.jtcvs.2013.10.050.
  3. Парная M.A., Морозов Ю.А., Гладышева В.Г. Использование метода тромбоэластографии для диагностики и выбора тактики коррекции нарушений системы гемостаза в кардиохирургической клинике. Вестник анестезиологии и реаниматологии. 2010; 7 (1): 28-33 @@Charnaya М.А., Morozov Yu.A., Gladysheva V.G. The use of thromboelastography for the diagnosis and choice of tactics for correcting disorders of the hemostasis system in a cardiac surgery clinic. Bulletin of anesthesiology and resuscitation. 2010; 7 (1): 28-33 (in Russ.).
  4. Ranucci М., Carlucci С., Isgro G. et al. Hypothermic cardiopulmonary bypass as a determinant of late thrombocytopenia following cardiac operations in pediatric patients. Acta Anaestheslol Scand. 2009; 53 (8): 1060-7. doi: 10.1111/J.1399-6576.2009.02010.x
  5. Trekova N.A, Solovova L.E., Gus’kov D.A. et al. Strategy of transfusion in cardiac and aortic surgery. Anesteziol Reanimatol. 2014; 3: 4-10.
  6. Леонов Н.П., Караськов A.M., Струнин O.B. Сравнение методов коррекции геморрагического синдрома у новорожденных и детей раннего возраста при кардиохирургических операциях. Сибирский научный медицинский журнал. 2016; 36 (2): 102-12 @@Leonov N.P., Karaskov А.М., Strunin O.V. Comparison of methods of correction of hemorrhagic syndrome in newborns and young children during cardiac surgery. Siberian Scientific Medical Journal. 2016; 36 (2): 102-12 (in Russ.).
  7. Бокерия Л.А, Самуилова Д.Ш., Аверина Т.Б. и др. Синдром системного воспалительного ответа у кардиохирургических больных. Бюллетень НЦССХ им. А.Н. Бакулева РАМН. 2004; 5 (12): 5-25 @@Bockeria L.A., Samuilova D.Sh., Averina T.B. and other Syndrome of systemic inflammatory response in cardiac surgery patients. Bulletin of the Scientific Center for Cardiovascular Surgery Im. A. N. Bakuleva RAMS. 2004; 5 (12): 5-25 (in Russ.).
  8. Бокерия Л.А., Купряшов A.A., Козар Е.Ф. и др. Роль педиатрических и кардиологических факторов для прогноза кровопотери у детей с врожденными пороками сердца после операций, выполненных в условиях искусственного кровообращения. Детские болезни сердца и сосудов. 2011; 4: 25-35 @@Bockeria L.A., Kupryashov А.А., Kozar E.F. et al. The role of pediatric and cardiological factors for the prognosis of blood loss in children with congenital heart defects after operations performed under cardiopulmonary bypass. Children’s diseases of the heart and blood vessels. 2011; 4: 25-35 (in Russ.).
  9. Баркаган Л.З. Нарушения гемостаза у детей. М.: Медицина, 1993; 176 с. @@Barkagan L.Z. Violations of hemostasis in children. M.: Meditsina, 1993; 176 p. (in Russ.).
  10. Кузник Б.И., Стуров В.Г., Левшин Н.Ю. и др. Геморрагические и тромботические заболевания и синдромы у детей и подростков: Патогенез, клиника, диагностика, терапия и профилактика. Новосибирск: Наука, 2018; 524 с. @@Kuznik B.I., Sturov V.G., Levshin N.Vu. et al. Hemorrhagic and thrombotic diseases and syndromes in children and adolescents: Pathogenesis, clinical picture, diagnosis, therapy and prevention. Novosibirsk: Nauka, 2018; 524 p. (in Russ.).
  11. Козар Е.Ф., Плющ М.Г., Самсонова H.H. и др. Состояние гемостаза у больных врожденными пороками сердца до и после хирургической коррекции. Тромбоз, гемостаз и реология. 2001; 2 (6): 26-7 @@Kozar E.F., Pliushch M.G., Samsonova N.N. et al. The state of hemostasis in patients with congenital heart defects before and after surgical correction. Thrombosis, hemostasis and rheology. 2001; 2 (6): 26-7 (in Russ.).
  12. Lequier L., Nikaidoh H., Leonard S.R. et al. Preoperative and postoperative endotoxemia in children with congenital heart disease. Chest. 2000; 117 (6): 1706-10. doi: 10.1378/chest.117.6.1706
  13. Razon Y., Erez E., Vidne B. etal. Recombinant factor Vila (NovoSeven) as a hemostatic agent after surgery for congenital heart disease. Paedlatr Anaesth. 2005; 15 (3): 235-40. doi: 10.1111/J.1460-9592.2005.01429jc
  14. Simpson E., Lin Y., Stanworth S. et al. Recombinant factor Vila for the prevention and treatment of bleeding in patients without haemophilia. Cochrane Database Syst Rev. 2012; 3: CD005011. doi: 10.1002/14651858.CD005011. pub4
  15. Кудлай Д.А. Разработка и применение отечественных рекомбинантных препаратов факторов свертывания крови VII, VIII, IX у детей с гемофилией А и B. Педиатрия им Г.Н. Сперанского. 2019; 98 (1): 9-17 @@Kudlay DA. Development and application of domestic recombinant preparations of blood coagulation factors VII, VIII, IX in children with hemophilia A and B. Pediatrics named after G.N. Speransky. 2019; 98 (1): 9-17 (in Russ.). doi: 10.24110/0031-403X-2019-98-1-9-17
  16. Галстян Г.М., Полеводова 0.A., Терехова И.В. и др. Применение тромбо-эластографии, теста генерации тромбина и клоттинговых тестов для оценки эффективности гемостатической терапии рекомбинантным активированным фактором VII у больных с ингибиторной формой гемофилии. Российский журнал детской гематологии и онкологии. 2017; 4 (4): 33-8 @@Galstyan G.M., Polevodova О.А., Terekhova I.V. et al. Application of thromboelastography, thrombin generation test and clotting tests to assess the effectiveness of hemostatic therapy with recombinant activated factor VII in patients with inhibitory hemophilia. Russian Journal of Pediatric Hematology and Oncology. 2017; 4 (4): 33-8 (in Russ.). doi: 10.17650/2311 -1267-2017-4-4-33-38
  17. Рыбка M.M., Самсонова H.H., Лобачева Г.В. и др. Эффективность и безопасность применения препарата Коагил-VII - эптаког альфа (активированный) при хирургической коррекции врожденных пороков сердца у новорожденных и детей раннего возраста. Тромбоз, гемостаз и реология. 2014; 57 (1): 9-14 @@Rybka М.М., Samsonova N.N., Lobacheva G.V. et al. The efficacy and safety of using the drug Coagil - VII - eptacog alpha (activated) in the surgical correction of congenital heart defects in newborns and young children. Thrombosis, hemostasis and rheology. 2014; 57 (1): 9-14 (in Russ.).
  18. Самсонова H.H., Рыбка M.M. Эффективность коррекции нарушений гемостаза рекомбинантным активированным фактором VII - Коагил-VII, концентратом протромбинового комплекса, в периоперационном периоде у кардиохирургических пациентов. Тромбоз, гемостаз и реология. 2016; 67 (3, прил. 1): 369-70 @@Samsonova N.N., Rybka M.M. Efficiency of correction of hemostasis disorders with recombinant activated factor VII - Coagil-VII, prothrombin complex concentrate, in the perioperative period in cardiac surgery patients. Thrombosis, hemostasis and rheology. 2016; 67 (3, Suppl. 1): 369-70 (in Russ.).
  19. Андреева Т.А., Зоренко В.Ю., Кудлай Д.А. и др. Исследование иммуно-генности российского рекомбинантного активированного фактора свертывания VII у больных гемофилией А, осложненной развитием ингибиторов. Педиатрия им. Г.Н. Сперанского. 2020; 99 (2): 206-15 @@Andreeva Т.А., Zorenko V.Yu., Kudlay D.A. et al. Study of the immunogenicity of the Russian recombinant activated coagulation factor VII in patients with hemophilia A complicated by inhibitors development. Pediatrics named after G.N. Speransky. 2020; 99 (2): 206-15 (in Russ.). doi: 10.24110/0031-403X-2020-99-2-206-215
  20. Hoffman M., Monroe D.M. 3rd. The action of high-dose factor Vila (FVIIa) in a cell-based model of hemostasis. Semin Hematol. 2001; 38 (4 suppl): 6-9. doi: 10.1016/S0037-1963(01 )90140-4

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