High Dose, Prolonged Epsilon Aminocaproic Acid Infusion, and Recombinant Factor VII for Massive Postoperative Retroperitoneal Hemorrhage following Splenectomy

Table 1

Postoperative transfusion requirements and degree of hemorrhage.

	Hematocrit (%)	Platelets; (K/L)	INR	Fibrinogen; (mg/dL)	Postoperative blood products (cumulative)
					PRBC; (units)	FFP; (units)	Plt; (units)
Baseline (2 hours preop)	25.9	42	1.2	361
Postoperative hour
12 hours	24.4	76	1	363	0	0	0
20 hours	23.3	62	1.1		2	0	1
28 hours^1	19.1	39	1.3	259	6	2	2
36 hours	17	61	1.4	211	9	5	4
44 hours^2	25.9	70	1.3	282	14	9	4
52 hours^3	25.9	99	1.1	341	16	9	5
60 hours	24.7	73	1.3	388	18	10	5
68 hours	26.5	46	1.2	475	19	10	5
76 hours^4	28	117	1.2	541	19	10	6
100 hours^5	28.2	132	1.1	327	19	10	6

hemorrhage identified. Factor VII given.
dose of factor VII and 5 g aminocaproic acid load.
aminocaproic acid infusion at 1 g/hr.
acid infusion decreased to 1 g/3 hrs.
hours after aminocaproic acid infusion discontinued.