Recombinant Activated Factor VII for Adjunctive Hemorrhage Control in Trauma

Abstract

The results of this report suggest that in trauma patients rFVIIa may play a role as an adjunctive hemostatic measure, in addition to surgical hemostatic techniques, and provides the motivation for controlled animal and clinical trials.

Blood Component Therapy in Obstetrics

“…However, the drug has been used in other situations with uncontrolled bleeding, including life-threatening obstetric hemorrhage [49,51,52]. Several case reports and reviews have described decreased blood product requirements in surgical and trauma patients with uncontrolled bleeding with the administration of rFVIIa [53,54]. The mechanism of action of rFVIIa is to augment the intrinsic clotting pathway by binding with tissue factor and directly activating factors IX and X [49,54].…”

Use of Recombinant Activated Factor VII in Cardiac Surgery for an Effective Treatment of Severe Intractable Bleeding

“…9,10) Conclusion: RFVIIa has been used for about a decade in the treatment of hemophilia patients with inhibitors of coagulation factors VIII and IX, particularly in those undergoing surgical procedures.…”

Management of Critical Bleeding in Trauma Patients: Between Recommendations and Reality

“…Animal models have shown that rFVIIa effectively decreases blood loss at trauma [45] and also increased evidence of its efficacy at trauma patients was found [46,47]. In a multicentre, double-blind, prospective, randomized, placebo-controlled trial rFVIIa was shown to be effective and safe in reducing PRBCs transfusion especially in blunt trauma patients, as well as showing a good safety profile [48] when used as an adjunct to trauma care [49].…”

“…In the absence of monitoring of the overall haemostasis, administration of rFVIIa and PCCs is unacceptable. The mechanism of action of rFVIIa suggests enhancement of haemostasis, which is limited to the site of injury without the activation of the coagulation process [47]. Therefore, its use in traumatic haemorrhage is rational.…”