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Introduction and Objectives: Inherited FVII deficiency is a rare hemorrhagic disorder.Clinical bleeding does not correlate with the level of FVII plasma activity. FVII involves in the extrinsic coagulation pathway. ROTEM is point of care method. EXTEM is one of ROTEM screening tests. EXTEM analyses the extrinsic pathway of coagulation. Aim of the study was to evaluate hemostatic effect and safety of rFVIIa treatment in pts with inherited FVII deficiency. Materials and Methods: The results of rFVIIa treatment were investigated in 4 pts (1 male, 3 females) with inherited FVII deficiency. Pts were treated with rFVIIa before gynecological (2), abdominal (1) and orthopedic surgery (1). Pts received 30 mcg/kg of rFVIIa (Koagil VII, Generium, Russia) before surgery. Plasma FVII activity, fibrinogen, INR, APTT, ROTEM and thromboelastography (TEG) parameters were investigated before rFVIIa administration, then in 15 minutes, in 2 hours, in 6 hours and in 12 hours. Results: Before rFVIIa administration median plasma FVII activity was low, CT EXTEM was long and INR was greater than 3. TEG, APTT and fibrinogen were in normal ranges (table 1, fig. 1). Fifteen minutes after rFVIIa administration FVII:C activity increased, INR and CT EXTEM decreased. Hemostatic effect of rFVIIa remained during 12 hours. During this period CT EXTEM correlated with INR (r = 0.97, p Conclusion: CT EXTEM allowed to evaluate hemostatic effect of rFVIIa in operating room and good correlated with INR in pts with inherited FVII deficiency. Disclosures No relevant conflicts of interest to declare.

Introduction and Objectives: MV in thrombocytopenic pts could be complicated by life threatening tracheobronchial bleeding. The systemic treatment with tranexamic acid or rFVIIa increases the risk of thromboembolic events. Presented in airspace tissue factor (TF) reacts as a cofactor in augmenting the activity of FVIIa 1000-fold. Topical treatment of the inhalation with rFVIIa has not been studied yet. The aim of the study was to evaluate hemostatic effect of rFVIIa inhalation for treatment of the tracheobronchial bleeding in MV thrombocytopenic pts. Materials and Methods: The results of rFVIIa inhalation were investigated in 5 acute leukemia pts (2 males, 3 female). All pts were mechanically ventilated through tracheostomy tube and had life threatening tracheobronchial bleeding. Before intervention all pts had low platelet count 50-120х109/l (median 65 х109/l), lowered Quick prothrombin (55-64%, median 58%), prolonged APTT (55-57s). Results. All pts received rFVIIa as an inhalation over five to ten minutes. For inhalation rFVIIa (Koagil VII, Generium, Russia, Vial of 2.4 mg) was diluted in 10 ml of isotonic saline. If, after 20 min, there is no response to rFVIIa second dose of rFVIIa (2.4 mg) as an inhalation was administrated. Bleeding was stopped in 3/5 pts, in 2 pts the intensity of bleeding decreased. There were no changes in APTT and Quick prothrombin registered. Median plasma FVII activity before inhalation was 82%, after inhalation - 73%. There were no changes on the TEG (figure 1). Thus, despite local hemostatic effect we did not registered systemic effects of rFIIa after inhalation Conclusion. Topical treatment of the tracheobronchial bleeding with rFVIIa inhalation provided hemostatic effect. There were not be systemic adverse effects in as much as the alveolocapillary membrane does not allow the transmembranous passage of rFVIIa. Disclosures No relevant conflicts of interest to declare.