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Hematology 2008

What Is the Evidence for the Off-label Use of Recombinant Factor VIIa (rFVIIa) in the Acute Reversal of Warfarin?

ASH Evidence-based Review 2008

Rachel P. Rosovsky1 and Mark A. Crowther2

Correspondence: Mark A. Crowther, MD, St. Joseph’s Hospital and McMaster University, 50 Charlton Ave., E, Rm. L-208, Hamilton, Ontario L8N 4A6, Canada; Phone: 905-521-6024; Fax: 905-540-6568; e-mail: crowthrm{at}mcmaster.ca

Abstract

A 47-year-old man presents with hypovolemic shock. He takes warfarin as a result of a mechanical mitral valve insertion 5 years prior, his INR at presentation is 8.4 and emergent CT reveals a very large retroperitoneal hematoma. Despite aggressive fluid and transfusion support he continues hypotensive, requiring ionotrope support. You are asked if he should receive recombinant factor VIIa.


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