Acute and Critical Care

Original Articles

Hematology
Recombinant Activated Factor VII as a Second Line Treatment for Postpartum Hemorrhage: Soon Chang Park, Seok Ran Yeom, Sang Kyoon Han, Young Mo Jo, Hyung Bin Kim; Korean J Crit Care Med. 2017;32(4):333-339. Published online November 30, 2017; DOI: https://doi.org/10.4266/kjccm.2016.00787

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Background
Severe or massive postpartum hemorrhage (PPH) has remained a leading cause of maternal mortality for decades across the world and it results in critical obstetric complications. Recombinant activated factor VII (rFVIIa) has emerged as a gold standard adjunctive hemostatic agent for the treatment of life-threatening PPH refractory to conventional therapies although it remains off-licensed for use in PPH. We studied the effects of rFVIIa on coagulopathy, transfusion volume, prognosis, severity change in Korean PPH patients.
Methods
A retrospective review of medical records between December 2008 and March 2011 indicating use of rFVIIa in severe PPH was performed. We compared age, rFVIIa treatment, transfusion volume, and Sequential Organ Failure Assessment (SOFA) score at the time of arrival in the emergency department and after 24 hours for patients whose SOFA score was 8 points or higher.
Results
Fifteen women with SOFA score of 8 and above participated in this study and eight received rFVIIa administration whereas seven did not. Patients’ mean age was 31.7 ± 7.5 years. There was no statistically significant difference in initial and post-24 hours SOFA scores between patients administered rFVIIa or not. The change in SOFA score between initial presentation and after 24 hours was significantly reduced after rFVIIa administration (P = 0.016).
Conclusions
This analysis aimed to support that the administration of rFVIIa can reduce the severity of life-threatening PPH in patients. A rapid decision regarding the administration of rFVIIa is needed for a more favorable outcome in severe PPH patients for whom there is no effective standard treatment.

Citations

Citations to this article as recorded by

Role of recombinant factor VIIa in the clinical management of severe postpartum hemorrhage: consensus among European experts
D. Surbek, J. Blatný, M. Wielgos, N. Acs, H. Edwards, O. Erez, J. L. Bartha, H. Madar, F. J. Mercier, D. Schlembach, G. C. Di Renzo
The Journal of Maternal-Fetal & Neonatal Medicine.2024;[Epub] CrossRef
Coagulation management and transfusion in massive postpartum hemorrhage
Christina Massoth, Manuel Wenk, Patrick Meybohm, Peter Kranke
Current Opinion in Anaesthesiology.2023; 36(3): 281. CrossRef
Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care
Sibylle Kietaibl, Aamer Ahmed, Arash Afshari, Pierre Albaladejo, Cesar Aldecoa, Giedrius Barauskas, Edoardo De Robertis, David Faraoni, Daniela C. Filipescu, Dietmar Fries, Anne Godier, Thorsten Haas, Matthias Jacob, Marcus D. Lancé, Juan V. Llau, Jens Me
European Journal of Anaesthesiology.2023; 40(4): 226. CrossRef

High-frequency Chest Wall Oscillation Therapy: Clinical Effectiveness in the Patients with Pulmonary Contusion: Dae Sup Lee, Sung Wook Park, Suk Ran Yeom, Sang Kyoon Han, Sung Hwa Lee, Ji Ho Ryu; Korean J Crit Care Med. 2011;26(4):256-260.; DOI: https://doi.org/10.4266/kjccm.2011.26.4.256

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Abstract PDF

BACKGROUND
Pulmonary contusion is the most common pulmonary parenchymal injury in blunt chest trauma and may constitute a life-threatening thoracic injury. In this study, we evaluated the usefulness of high-frequency chest wall oscillation (HFCWO) therapy in patients with pulmonary contusion.
METHODS
Patients with lung contusion either received HFCWO therapy using the Vest system (Vest group; n = 18) or received conventional chest physiotherapy (non-Vest group; n = 23). The physiological parameters of the patients, length of stay in hospital and ICU, and the duration of mechanical ventilation were compared between the two groups. Variables, including pulmonary contusion score, percentage of patients receiving mechanical ventilation therapy, and PaO2/FiO2 ratio, were also analyzed.
RESULTS
The pulmonary contusion score was higher in the Vest group (p < 0.01), and mechanical ventilation was used more frequently in the Vest group (p = 0.027). Improvement in the PaO2/FiO2 ratio over the first 48 h did not differ between the Vest and Non-Vest groups. No significant differences in the physiological parameters, hospital and ICU stays, and duration of mechanical ventilation were observed between the two groups.
CONCLUSIONS
The therapeutic effect of the Vest system in patients with pulmonary contusion was similar to that of conventional chest physiotherapy. Therefore, the Vest system could be considered as an airway clearance technique in the management of patients with pulmonary contusion.

Citations

Citations to this article as recorded by

Comparative Study of High Frequency Chest Wall Oscillation and Traditional Chest Physical Therapy in Intensive Care Unit Patients
Yu-Ping Lin, Heng-Hsin Tung, Tsae-Jyy Wang
Journal of Comprehensive Nursing Research and Care.2017;[Epub] CrossRef

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