The role of recombinant factor VIIa in the treatment of life-threatening haemorrhage in blunt trauma

• Published in: Injury Vol. 36; no. 4; pp. 495 - 500
• Main Authors: Geeraedts, L.M.G., Kamphuisen, P.W., Kaasjager, H.A.H., Verwiel, J.M.M., van Vugt, A.B., Frölke, J.P.M.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.04.2005; Elsevier
• Subjects: Adolescent; Adult; Biological and medical sciences; Blood coagulation disorder; Blunt injury; Factor VII - therapeutic use; Factor VIIa; Female; Haemorrhage; Hematologic and hematopoietic diseases; Hemorrhage - etiology; Hemorrhage - physiopathology; Hemorrhage - prevention & control; Hemostasis - physiology; Humans; Male; Medical sciences; Middle Aged; Multiple Trauma - complications; Multiple Trauma - drug therapy; Multiple Trauma - physiopathology; Platelet diseases and coagulopathies; Recombinant Proteins - therapeutic use; Retrospective Studies; Treatment Outcome; Wounds, Nonpenetrating - complications; Wounds, Nonpenetrating - drug therapy; Wounds, Nonpenetrating - physiopathology; Blood coagulation disorder; Blunt injury; Haemorrhage; Factor VIIa; Blood coagulation; Transfusion; Hemopathy; Hemorrhage; Blood plasma; Need; Hemophilia; Complication; Medical record; Human; Critically ill; Red blood cell; Method; Trauma; Genetic disease; Case study; Platelet; Treatment; Follow up study; Register; Coagulopathy
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2004.08.001

Recombinant factor VIIa (rFVIIa) is a novel haemostatic agent originally developed to treat bleeding in haemophiliacs. Several case reports suggest effectiveness of rFVIIa in the treatment of patients without pre-existing bleeding disorders. The aim of this study is to evaluate treatment with recombinant (rFVIIa) in blunt trauma patients with uncontrolled bleeding. This study was designed as a retrospective case review. Consecutive patients with life-threatening uncontrolled bleeding due to blunt trauma who were treated with rFVIIa were selected. Data were obtained from medical records. A total of eight blunt trauma patients were treated with rFVIIa for uncontrolled bleeding. After treatment the need for transfusion of red blood cells (RBC) decreased significantly from 31.3 ± 15.8 to 6.1 ± 6.8 units ( P = 0.003), fresh frozen plasma (FFP) from 13.3 ± 6.6 to 5 ± 6.3 units ( P = 0.02), and platelets from 3.6 ± 1.8 to 1.5 ± 2.3 units ( P = 0.01). Three patients died of non-bleeding complications. The other five fully recovered. Treatment with rFVIIa reduced or stopped bleeding in all patients. No adverse events were registered. Prospective studies are mandatory to elucidate the role of rFVIIa in blunt trauma.