Possible role of recombinant activated factor VII (RFVIIa) in the control of hemorrhage associated with massive trauma.

Martinowitz U, Kenet G, Lubetski A, Luboshitz J, Segal E
Can J Anaesth 2002;49(10):S15-S20.
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This is a report on the largest series on the use of rFVIIa in treating patients suffering from uncontrolled bleeding as a result of trauma in spite of surgical treatment and blood transfusion. There were 19 patients who received 1-3 doses of rFVIIa, and bleeding was controlled in 15 of them. Transfusion requirement was reduced, and shortening in PT and APTT was noticed. In spite of high risk of systemic coagulopathy in this group, treatment with rFVIIa was not complicated by DIC, but one patient suffered with clinical DVT. The review concludes that these encouraging anecdotal reports require controlled studies to prove the role of rFVIIa in the management of severe bleeding secondary to trauma.

– Maadh Aldouri