Efficacy, Safety, and Strategies for Recombinant-Activated Factor VII in Cardiac Surgical Bleeding: A Narrative Review.

Authors: Kidd B; Sutherland, L; Jabaley, CS.; Flynn, B.

Affiliations: Division of Critical Care Medicine, Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS ; Division of Critical Care Medicine, Department of Anesthesiology, Columbia University, New York, NY ; Division of Critical Care Medicine, Department of Anesthesiology, Emory University, Atlanta, GA; Emory Critical Care Center, Atlanta, GA.

Publication: Journal of Cardiothoracic and Vascular Anesthesia ; 2021

Abstract: As perioperative bleeding continues to be a major source of morbidity and mortality in cardiac surgery, the search continues for an ideal hemostatic agent for use in this patient population. Transfusion of blood products has been associated both with increased costs and risks, such as infection, prolonged mechanical ventilation, increased length of stay, and decreased survival. Recombinant-activated factor VII (rFVIIa) first was approved for the US market in 1999 and since that time has been used in a variety of clinical settings. This review summarizes the existing literature pertaining to perioperative rFVIIa, in addition to society recommendations and current guidelines regarding its use in cardiac surgery.