Recombinant Activated Factor Vii (rFVIIa/ NovoSeven®) In The Management Of Massive Bleeding In Hospital Universiti Sains Malaysia
| dc.contributor.author | Mohd Shah, Nurfatin | |
| dc.date.accessioned | 2017-10-06T06:56:05Z | |
| dc.date.available | 2017-10-06T06:56:05Z | |
| dc.date.issued | 2017-09 | |
| dc.description.abstract | Massive bleeding has been a one of the contributing causes of death in the world. It is crucial for physicians to establish haemostasis during this condition. Currently, there are various type of methods to arrest bleeding with different efficiency, safety profile and outcome. One of the novel haemostatic agent is recombinant activated factor VII (rFVIIa). There has been a considerable controversy on usage of rFVIIa as one of the option to stop bleeding among non-haemophiliac patients. The aim of this study is to determine the outcome of off-label use of rFVIIa to treat bleeding among the non-haemophiliac patients in Hospital Universiti Sains Malaysia. Medical records of 76 non-haemophiliac patients treated with rFVIIa for desperate bleeding over 11-year period at the single institution administering rFVIIa were recorded for treatment indications, 24-hours and 30-day mortality, transfusion need and coagulation profiles. The patients were classified into trauma, post-partum, other surgery and medical. Complication of thromboembolism events are assessed among patients. rFVIIa are most administered in medical patients followed by trauma, other surgery and post-partum. Overall, each category reported less than 25% risk of 24-hour mortality while various percentage for mortality at day-30. Blood and blood products (packed red blood cell, fresh frozen plasma, platelet, cryoprecipitate) needed are significantly reduced in patients receiving rFVIIa. There is also improvement of coagulation profiles (prothrombin time, activated partial thromboplastin time, international normalized ratio) in patients before and after treated with rFVIIa. None of thromboembolism events described for this study. Statistical significance was assessed at p<0.05. rFVIIa therapy is efficient for immediate response for those suffering from massive haemorrhage. Patients received rFVIIa were less likely to require further packed cells and blood product transfusion. It was accompanied by a significant improvement in measurement of coagulation parameters. rFVIIa was not associated with incidence of postoperative thromboembolism in this study. | en_US |
| dc.identifier.uri | http://hdl.handle.net/123456789/4832 | |
| dc.language.iso | en | en_US |
| dc.publisher | Universiti Sains Malaysia | en_US |
| dc.subject | Massive bleeding has been a one | en_US |
| dc.subject | causes of death in the world. | en_US |
| dc.title | Recombinant Activated Factor Vii (rFVIIa/ NovoSeven®) In The Management Of Massive Bleeding In Hospital Universiti Sains Malaysia | en_US |
| dc.type | Thesis | en_US |
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