This paper reports the use of rFVIIa in 81 patients who suffered with traumatic bleeding over a period of 30 months in a large trauma center. The center set guidelines for using rFVIIa in patients with severe uncontrolled bleeding and associated coagulopathy. Results were compared to series of matched control groups for comparison. There was improvement of coagulopathy in all patients, control of bleeding in 64/81 patients, 34 of whom survived. There was no evidence of thrombotic episodes in any patient 7 days after therapy. Although the study did not elicit survival benefit in comparison to control groups, the results were still thought to be encouraging, especially that it was difficult to define matched controls. It was felt necessary to carry out large randomized prospective multicenter trials to identify proper patient selection, timing and dose of rFVIIa.

– Maadh Aldouri