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Recombinant activated factor VII (rFVIIa) as a hemostatic agent in liver disease: A break from convention in need of controlled trials by Stephen H. Caldwell; Charissa Chang; B. Gail Macik is a Medicine article available to read on EtoBox.

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The management of coagulopathy in patients with acute and chronic liver disease has undergone little change in many years despite advances in our understanding of the pathogenesis of this problem. In general, deficiency of clotting factors as a result of poor hepatic synthetic function accounts for most of the coagulopathy. However, other processes such as disseminated intravascular coagulation (DIC), hyperfibrinolysis, dysfibrinogenemia, hemolysis, and a decrease in number or function of platelets may be present and thus add to the complexity of the problem. Coexisting portal hypertension and the associated risks of volume expansion, renal failure, and endothelial dysfunction add even more difficulty to the management of these patients. The clinician's despair is only exacerbated by uncertainty regarding the significance of laboratory indices of coagulation and the lack of agreement between health care providers regarding how to use these indices. Simple, conventional interventions such as vitamin K or plasma administration often produce only limited amelioration, and the latter carries the potential disadvantage of volume overexpansion as well as the risk of infection and transfu

Who reads Recombinant activated factor VII (rFVIIa) as a hemostatic agent in liver disease: A break from convention in need of controlled trials?

Author

Stephen H. Caldwell; Charissa Chang; B. Gail Macik

Publisher

Ovid Technologies (Wolters Kluwer Health)

Published

2004

Language

EN

Field

Medicine (Health Sciences)