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Cosar H, Isik H, Cakır SC, Yar N, Goksen B, Tokbay H, Kertmen H, Erdoğan N, Durak I. Recombinant Activated Factor VIIa (rFVIIa) Treatment in Very-Low-Birth-Weight (VLBW) Premature Infants with Acute Pulmonary Hemorrhage: A Single-Center, Retrospective Study. Paediatr Drugs 2017; 19:53-58. [PMID: 27826851 DOI: 10.1007/s40272-016-0203-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM We aimed to evaluate the efficacy of intravenous administration of recombinant activated factor VIIa (rFVIIa) for acute pulmonary hemorrhage treatment in very-low-birth-weight (VLBW) premature infants. PATIENTS AND METHODS This study was carried out retrospectively in premature infants with pulmonary hemorrhage that were ≤30 weeks gestational age or <1250 g birth weight. The data of all VLBW premature infants with pulmonary hemorrhage who were hospitalized in our neonatal intensive care unit between 01 January 2013 and 31 December 2015 were evaluated. Group 1 (n = 21) received rFVIIa support within the first 30 min of pulmonary hemorrhage plus conventional treatment, while Group 2 (n = 21) received conventional treatment only. RESULTS The number of patients whose pulmonary hemorrhage was stopped within the first 2 h was significantly higher in Group 1 than Group 2 (n = 14 vs n = 4; p = 0.002). After pulmonary hemorrhage, hemoglobin values of Group 1 were higher than Group 2 (11.12 ± 1.06 vs 10.14 ± 1.59 g/dL; p = 0.024). Erythrocyte suspension (1.43 ± 4.51 vs 5.71 ± 7.46 mL/kg; p = 0.030) and fresh frozen plasma use (5.71 ± 8.10 vs 19.52 ± 12.44 mL/kg; p < 0.001) in Group 1 were lower than those of Group 2. Prothrombin time, activated partial thromboplastin time, and international normalized ratio values in Group 1 were lower than those of Group 2 (p < 0.05). No statistically significant difference was identified in recurrence of pulmonary hemorrhage after 72 h, overall mortality, mortality from pulmonary hemorrhage, surfactant use, intubation time, hospitalization duration, intraventricular hemorrhage (IVH), severe IVH, patent ductus arteriosus rates, or short-term complication rates. CONCLUSION rFVIIa administration was observed to be effective in stopping pulmonary hemorrhage, reducing blood product requirement, and improving coagulation test parameters. Prospective studies are needed to evaluate the efficacy, reliability, and long-term results of rFVIIa in the prevention and treatment of pulmonary hemorrhage in premature infants.
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Affiliation(s)
- Hese Cosar
- Neonatal Intensive Care Unit, Private Egepol Hospital, 507 Street, No: 3, 35270, Konak, Izmir, Turkey.
| | - Halil Isik
- Neonatal Intensive Care Unit, Private Egepol Hospital, 507 Street, No: 3, 35270, Konak, Izmir, Turkey
| | - Salih Cagrı Cakır
- Neonatal Intensive Care Unit, Private Egepol Hospital, 507 Street, No: 3, 35270, Konak, Izmir, Turkey
| | - Nese Yar
- Neonatal Intensive Care Unit, Private Egepol Hospital, 507 Street, No: 3, 35270, Konak, Izmir, Turkey
| | - Bulent Goksen
- Neonatal Intensive Care Unit, Private Egepol Hospital, 507 Street, No: 3, 35270, Konak, Izmir, Turkey
| | - Hakan Tokbay
- Neonatal Intensive Care Unit, Private Egepol Hospital, 507 Street, No: 3, 35270, Konak, Izmir, Turkey
| | - Hasan Kertmen
- Neonatal Intensive Care Unit, Private Egepol Hospital, 507 Street, No: 3, 35270, Konak, Izmir, Turkey
| | - Nihal Erdoğan
- Neonatal Intensive Care Unit, Private Egepol Hospital, 507 Street, No: 3, 35270, Konak, Izmir, Turkey
| | - Ikbal Durak
- Neonatal Intensive Care Unit, Private Egepol Hospital, 507 Street, No: 3, 35270, Konak, Izmir, Turkey
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