This article is part of the supplement: Recombinant activated factor VIIa and hemostasis in critical care: a focus on trauma
Review
Clinical experiences and current evidence for therapeutic recombinant factor VIIa treatment in nontrauma settings
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* Corresponding author: R Michael Grounds m.grounds@blueyonder.co.uk
1 Adult Intensive Care Unit, St George's Hospital, London, UK
2 COL (retired) US Army Medical Corps, Deputy Chief, Blood Services Section, Department of Transfusion Medicine, Clinical Centre, National Institutes of Health, Bethesda, Maryland, USA
Critical Care 2005, 9(Suppl 5):S29-S36 doi:10.1186/cc3783
Published: 7 October 2005Abstract
The hemostatic properties of recombinant activated factor VII (rFVIIa) are established in patients with inherited or acquired hemophilia with inhibitors and in patients with congenital factor VII deficiencies. Emerging clinical evidence suggests that there may be a wider role for rFVIIa in the management of hemorrhage associated with traumatic injury/accident and severe bleeding associated with critical surgery. This article considers recent data from studies in which rFVIIa was used in an attempt to control bleeding in clinical situations as diverse as coagulopathy associated with chronic liver disease, massive perioperative bleeding and bleeding during prostatectomy, organ transplantation and orthopedic surgery, uncontrollable obstetric hemorrhage, and intracerebral hemorrhage. In nontrauma settings involving acute and potentially life threatening bleeding, there may be a place for rFVIIa as adjunctive therapy in the control of hemostasis.