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  • Mehanizem delovanja rekombinantnega faktorja VIIa in uporaba pri stanjih, ki jih spremlja huda krvavitev = Mode of action of recombinant factor VIIa and the use in severe haemorrhage states
    Stecher, Adela ; Kremžar, Boriana, 1943-
    Background Diffuse non-surgical life threatening haemorrhages are common causeof death in surgical patients. They are usually caused by a disorder of haemostasis of different aetiologies. When the ... haemorrhage can not be stopped with standard measures, we can resort to the rFVIIa preparation. Numerous studies have proven the effectiveness of rFVII in treating of untractable haemorrhages as well as in preventing the haemorrhages in patients with known blood coagulation disorders. When high dosages of rFVIIa, which binds to tissue factor (TF), are administered, huge quantity of thrombin forms. Thrombin affects fibrinogen and at the same time activates huge quantity of factor XIII and of Thrombin Activatable Fibrinolysis Inhibitor (TAFI). The created fibrin clot is more resistant to fibrinolysis than a normal one. It isalso important to know that rFVIIa in high concentrations can activate factors IX and X on the surface of thrombocytes, independently of TF. The effect of rFVIia is limited to the location of injury but despite this there is a possibility of thrombosis. Because rFVIIa binds not only to the TF containing cells, but also to injured cells containing phospatidyl serine, caution is needed where septic patients, patients with extensive tissue necrosis or with atherosclerotic changes are concerned. The following facts must hold true in order for rFVIIa to be administered: the haemorrhage is non-surgical and does not stop after application of standard measures; the patient does not suffer from hypothermia; the platelets value is higher than 50 x 10/l (except when thrombocytopenia is the indication for use); the fibrinogen value is higher than 50 mg/l; blood pH is higher than 7.2. (Abstract truncated at 2000 characters)
    Vir: Zdravniški vestnik : glasilo Slovenskega zdravniškega društva = Slovenian medical journal = journal of Slovenian Medical Association. - ISSN 1318-0347 (Letn. 75, št. 4, apr. 2006, str. 241-246)
    Vrsta gradiva - članek, sestavni del
    Leto - 2006
    Jezik - slovenski
    COBISS.SI-ID - 21155289

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