Is recombinant FVIIa the magic bullet in the treatment of major bleeding? [Editorial]
This editorial reviews the use of rFVIIa in management of surgical and post-partum hemorrhage and highlights that in spite of anecdotal evidence
from published case reports and small series of patients, there is still lack of clear evidence of its efficacy from large randomized trials. This
may be partly due to design of these protocols such as the liver and pelvic surgery studies in which rFVIIa was given too early in the surgical
procedure and before the skin incision. However, benefit of use rFVIIa was seen in using it following acute intracerebral and post-partum hemorrhage. Unanswered questions remain regarding optimal timing and dose, laboratory
monitoring and adequate adjuvant treatment with blood products or hemostatic agents or procedures.
– Maadh Aldouri