Tuesday April 13, 2010
Q: 58 year old male is in ICU after cardiac surgery. Patient is showing significant post-operative bleeding. Patient continue to bleed despite correction of all coagulation profiles via blood products. Surgeon wants to try more conservative measures before taking back to OR due to high risk and associated morbidities. While going through chart you find that patient has history of anaphylaxis with use of bovine meat. Which one intervention is out of question?
Answer: Use of Factor 7
Factor -seven is contraindicated in patients with known hypersensitivity to mouse, hamster, or bovine proteins. NovoSeven contains amounts of proteins derived from the manufacturing and purification processes such as mouse IgG (maximum of 1. 2 ng/mg), bovine IgG (maximum of 30 ng/mg), and protein from BHK-cells and media (maximum of 19ng/mg).
Recombinant factor 7 is now widely avaialable, marketed as novoseven. This can still be given to this patient without significant interaction.
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