Evaluation of the role of recombinant activated factor VII (NovoSeven) as a rescue haemostatic therapy in postcardiopulmonary bypass surgical patients
Bibliographic record
Abstract
Evaluation of the safety and efficacy of recombinant activated factor VII (NovoSeven) when used as a rescue haemostatic agent in refractory bleeding post bypass surgery. A retrospective cohort study of all postcardiopulmonary bypass patients with uncontrolled bleeding despite conventional treatment (platelets, fresh frozen plasma, cryoprecipitate, and Aprotonin) who received recombinant factor VII as a rescue therapy over 12 months in a cardiothoracic centre. Eight patients received NovoSeven (90 μg/kg). Seven achieved significant reduction in blood loss. The mean blood loss via thoracic drains 6 hours before and 2 hours after NovoSeven administration were 341 ml/hour vs 117 ml/hour ( P = 0.01) (Figure 1 ). On average, 5.3 units/patient packed red blood cells, 2 pools/patient platelets, 19 ml/kg/patient fresh frozen plasma and 148 ml/patient cryoprecipitate were used prior to NovoSeven administration. Five patients required further blood transfusion with a mean of 2.2 units/patient over the next 12 hours. Two of the eight patients developed thromboembolic complications including portal vein thrombosis and spinal cord infarction. Of these two, one died secondary to coagulopathic complications post initiation of warfarin therapy 2 weeks post surgery. Mean hourly drain output 6 hours pre and 2 hours post NovoSeven administration. Our results support the evidence that recombinant factor VII is an effective haemostatic agent that can be used in patients with uncontrolled bleeding in postcardiopulmonary bypass surgery. Despite its high cost, there is an advantage in terms of effectiveness to support its use. However, its potential thromboembolic risk remains a concern and current evidence may restrict its use only as a rescue therapy following failed conventional treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".