Recombinant Factor VIIa Reduces Bleeding after Blunt Liver Injury in a Pig Model of Dilutional Coagulopathy under Severe Hypothermia

Henri M. H. Spronk; Till Braunschweig; Rolf Rossaint; Dirk C. Wuest; Rene van Oerle; Brian Lauritzen; Rene Tolba; Oliver Grottke

doi:10.1371/journal.pone.0113979

Recombinant Factor VIIa Reduces Bleeding after Blunt Liver Injury in a Pig Model of Dilutional Coagulopathy under Severe Hypothermia

Henri M. H. Spronk, Till Braunschweig, Rolf Rossaint, Dirk C. Wuest, Rene van Oerle, Brian Lauritzen, Rene Tolba, Oliver Grottke^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background Recombinant factor VIIa (rFVIIa) is registered for use in haemophilia with inhibitors and other rare bleeding disorders, but has also been used in various other clinical conditions to terminate life-threatening bleeding. Underlying conditions (e.g. coagulopathy) and dosing may affect treatment efficacy. The objective of the present study was to evaluate the impact of increasing doses of rFVIIa on blood loss and coagulation assays in haemodiluted and hypothermic pigs undergoing blunt liver injury. Methods A grade III blunt liver injury was induced in 28 pigs after 70% haemodilution and cooling to 32.6-33.4 degrees C. Ten minutes after trauma, animals randomly received placebo or 90, 180 or 360 mu g/kg rFVIIa. Global coagulation parameters, thromboelastometry (TEM) and plasma thrombin generation (TG) were determined at different time points during the observation period of 120 minutes. Results Total blood loss was significantly lower following 90 mu g/ kg rFVIIa (1206 [1138-1470] mL) relative to placebo (2677 [2337-3068] mL; p

Original language	English
Article number	e0113979
Journal	PLOS ONE
Volume	10
Issue number	6
DOIs	https://doi.org/10.1371/journal.pone.0113979
Publication status	Published - 22 Jun 2015

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@article{90abbd73cc3f453a99414256913fa709,

title = "Recombinant Factor VIIa Reduces Bleeding after Blunt Liver Injury in a Pig Model of Dilutional Coagulopathy under Severe Hypothermia",

abstract = "Background Recombinant factor VIIa (rFVIIa) is registered for use in haemophilia with inhibitors and other rare bleeding disorders, but has also been used in various other clinical conditions to terminate life-threatening bleeding. Underlying conditions (e.g. coagulopathy) and dosing may affect treatment efficacy. The objective of the present study was to evaluate the impact of increasing doses of rFVIIa on blood loss and coagulation assays in haemodiluted and hypothermic pigs undergoing blunt liver injury. Methods A grade III blunt liver injury was induced in 28 pigs after 70% haemodilution and cooling to 32.6-33.4 degrees C. Ten minutes after trauma, animals randomly received placebo or 90, 180 or 360 mu g/kg rFVIIa. Global coagulation parameters, thromboelastometry (TEM) and plasma thrombin generation (TG) were determined at different time points during the observation period of 120 minutes. Results Total blood loss was significantly lower following 90 mu g/ kg rFVIIa (1206 [1138-1470] mL) relative to placebo (2677 [2337-3068] mL; p",

author = "Spronk, {Henri M. H.} and Till Braunschweig and Rolf Rossaint and Wuest, {Dirk C.} and {van Oerle}, Rene and Brian Lauritzen and Rene Tolba and Oliver Grottke",

year = "2015",

month = jun,

day = "22",

doi = "10.1371/journal.pone.0113979",

language = "English",

volume = "10",

journal = "PLOS ONE",

issn = "1932-6203",

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T1 - Recombinant Factor VIIa Reduces Bleeding after Blunt Liver Injury in a Pig Model of Dilutional Coagulopathy under Severe Hypothermia

AU - Spronk, Henri M. H.

AU - Braunschweig, Till

AU - Rossaint, Rolf

AU - Wuest, Dirk C.

AU - van Oerle, Rene

AU - Lauritzen, Brian

AU - Tolba, Rene

AU - Grottke, Oliver

PY - 2015/6/22

Y1 - 2015/6/22

N2 - Background Recombinant factor VIIa (rFVIIa) is registered for use in haemophilia with inhibitors and other rare bleeding disorders, but has also been used in various other clinical conditions to terminate life-threatening bleeding. Underlying conditions (e.g. coagulopathy) and dosing may affect treatment efficacy. The objective of the present study was to evaluate the impact of increasing doses of rFVIIa on blood loss and coagulation assays in haemodiluted and hypothermic pigs undergoing blunt liver injury. Methods A grade III blunt liver injury was induced in 28 pigs after 70% haemodilution and cooling to 32.6-33.4 degrees C. Ten minutes after trauma, animals randomly received placebo or 90, 180 or 360 mu g/kg rFVIIa. Global coagulation parameters, thromboelastometry (TEM) and plasma thrombin generation (TG) were determined at different time points during the observation period of 120 minutes. Results Total blood loss was significantly lower following 90 mu g/ kg rFVIIa (1206 [1138-1470] mL) relative to placebo (2677 [2337-3068] mL; p

AB - Background Recombinant factor VIIa (rFVIIa) is registered for use in haemophilia with inhibitors and other rare bleeding disorders, but has also been used in various other clinical conditions to terminate life-threatening bleeding. Underlying conditions (e.g. coagulopathy) and dosing may affect treatment efficacy. The objective of the present study was to evaluate the impact of increasing doses of rFVIIa on blood loss and coagulation assays in haemodiluted and hypothermic pigs undergoing blunt liver injury. Methods A grade III blunt liver injury was induced in 28 pigs after 70% haemodilution and cooling to 32.6-33.4 degrees C. Ten minutes after trauma, animals randomly received placebo or 90, 180 or 360 mu g/kg rFVIIa. Global coagulation parameters, thromboelastometry (TEM) and plasma thrombin generation (TG) were determined at different time points during the observation period of 120 minutes. Results Total blood loss was significantly lower following 90 mu g/ kg rFVIIa (1206 [1138-1470] mL) relative to placebo (2677 [2337-3068] mL; p

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DO - 10.1371/journal.pone.0113979

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SN - 1932-6203

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JO - PLOS ONE

JF - PLOS ONE

IS - 6

M1 - e0113979

ER -

Recombinant Factor VIIa Reduces Bleeding after Blunt Liver Injury in a Pig Model of Dilutional Coagulopathy under Severe Hypothermia

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