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001-es BibID:bibEBI00018625
Első szerző:Udvardy Miklós (belgyógyász, haematológus)
Cím:Succesful control of massive coumarol induced acute upper GI bleeding and correction of prothrombin time by recombinant active Factor VII (Eptacog-alpha, NovoSeven) in a patient with a prosthetic aortic valve and two malignancies (chronic límphoid leukaemia and lung cancer) / Udvardy, M., Telek, B., Mezey, G., Batár, P., Altorjay, I.
Dátum:2004
Megjegyzések:Severe, life-threatening acute upper gastrointestinal bleeding may occasionally occur in patients receiving coumarol prophylaxis for prosthetic heart valves. These patients are exposed to two potential, serious risks: bleeding due to the severe blood loss induced by excessive anticoagulant effect or as a consequence of the cessation of anticoagulation subsequent thrombotic occlusion of the valve and loss of patency. Herein a short case report is presented. The elderly male patient had a prosthetic valve in the aortic position and also suffered from two malignant diseases: chronic lymphocytic leukaemia and a more recently developed lung cancer with metastatic spread into both lungs. The patient had a major gastrointestinal bleed, leading to a sudden fall of haematocrit (0.09), and to a collapse of peripheral circulation due to too excessive a coumarol effect (International Normalized Ratio > 8). An acute left ventricular failure developed during the early period of the emergency blood transfusion, so the correction of prothrombin time by fresh-frozen plasma (due to the large volume requirement) was not feasible. The patient received 50 microg/kg intravenous bolus of NovoSeven (recombinant active factor VII) in an almost desperate situation. The International Normalized Ratio changed to 2.1 in 30 min; bleeding had stopped immediately. There was neither evidence of disseminated intravascular coagulation (in spite of the age and underlying diseases) nor loss of valve patency or infective endocarditis during follow-up. This modest report may call attention to the potential use of recombinant active factor VII in the coumarol-induced severe bleeding episodes of prosthetic heart valve patients.
Tárgyszavak:Orvostudományok Elméleti orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Blood Coagulation and Fibrinolysis. - 15 : 3 (2004), p. 265-267. -
További szerzők:Telek Béla (1948-) (belgyógyász, haematológus) Mezei Gabriella (1969-) (belgyógyász) Batár Péter (1969-) (belgyógyász, haematológus) Altorjay István (1954-) (belgyógyász, gasztroenterológus, onkológus)
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