Objective Report medical response to recombinant factor VIIa inside a cohort of critically sick infants. from the babies. Prothrombin period and activated partial thromboplastin period decreased subsequent treatment with element VIIa LY294002 significantly. Level of plasma transfusions considerably decreased pursuing treatment with LY294002 element VIIa (p=0.02). Thrombosis happened in 1 (11%) baby. LY294002 Six (33%) babies passed away within 72 hours of treatment and general mortality was 10/18 (56%). Summary Treatment with element VIIa at dosages of 90 mcg/kg improved LY294002 coagulation research and decreased the necessity for plasma transfusions in several critically sick babies without significant risk. Element VIIa may be a highly effective addition to current treatment modalities for refractory hemorrhage in babies. sepsis 8 times after rFVIIa therapy and two of respiratory failing (73 days and 197 days after rFVIIa therapy) (Table 4). Overall hospital mortality was 10/18 (56%). Table 4 Clinical Outcomes of Infants treated with recombinant factor VIIa DISCUSSION There are a number of reports describing the off-label use of rFVIIa in older infants and children for the treatment of refractory bleeding and prophylaxis for surgical procedures3-15. However the experience in premature infants is scarce. Here we report a large case series of premature infants treated with rFVIIa in the NICU. The indications for use of rFVIIa in this cohort are similar to the ones previously reported: pulmonary hemorrhage gastrointestinal hemorrhage NEC subgaleal hemorrhage subdural hematoma and post-surgical hemorrhage16-26. The overall rate of hemostasis in our cohort (72%) is comparable to that of these published reports for infants of varying age groups. A similar rate (69%) was noted among preterm infants in our study. Hemostasis was achieved in all of the infants with pulmonary hemorrhage (5/5) ranging in gestational age from 24 to 32 weeks after 1-3 doses of 90 mcg/kg of rFVIIa. Two case reports have described the successful use of rFVIIa for treatment of preterm infants with pulmonary hemorrhage Cetin et al. reported on a single case and Olomu on 2 infants using doses of 50-120 mcg/kg16 17 One infant in our cohort achieved hemostasis after receiving two doses of rFVIIa for gastrointestinal hemorrhage refractory to vitamin K and blood product transfusions including FFP cryoprecipitate platelet and packed red blood cells. Similarly Hunseler et al treated one 27 week infant with a large gastrointestinal tract hemorrhage unresponsive to vitamin K FFP and platelet transfusions. In that full case effective hemostasis was achieved after a single 110 mcg/kg dose of rFVIIa18. Overall Rabbit Polyclonal to p300. inside our cohort medical hemostasis had not been accomplished in five of eighteen babies (28%). The non responders included 2 early babies with intracranial hemorrhage 2 babies with DIC and 1 baby with a big hemorrhagic sacrococcygeal teratoma (Desk 4 patients.