title: Early use of recombinant factor VIIa improves mean arterial pressure and may potentially decrease mortality in experimental hemorrhagic shock: a pilot study.
abstract: BACKGROUND
  Recombinant factor VIIa (rFVIIa) is used for treatment of bleeding episodes in hemophilia patients who develop inhibitors to factors VIII and IX. We tested the hypothesis that administration of rFVIIa early after injury would decrease bleeding and improve survival after experimental hepatic trauma.
  
  
  METHODS
  Anesthetized swine were cannulated for blood sampling and hemodynamic monitoring. Avulsion of left median lobe of the liver induced uncontrolled hemorrhage. After a 10% reduction of mean arterial pressure, animals were blindly randomized to receive intravenous rFVIIa (180 microg/kg) (n = 6) or placebo (n = 7).
  
  
  RESULTS
  Mortality was 43% (three of seven) in controls versus 0% with rFVIIa (p = 0.08, chi2). Significantly shorter prothrombin time and higher mean arterial pressures were observed in the rFVIIa group.
  
  
  CONCLUSIONS
  Intravenous administration of rFVIIa early after induction of hemorrhage shortens prothrombin time and improves mean arterial pressure. A trend toward improved survival was observed.
authors.affiliation: Division of Trauma and Surgical Critical Care, University of Miami School of Medicine, Miami, Florida 33101, USA.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Lynn
authors.forename: Igor
authors.initials: I
authors.lastname: Jerokhimov
authors.forename: Dory
authors.initials: D
authors.lastname: Jewelewicz
authors.forename: Charles
authors.initials: C
authors.lastname: Popkin
authors.forename: Edward W
authors.initials: EW
authors.lastname: Johnson
authors.forename: Qammar N
authors.initials: QN
authors.lastname: Rashid
authors.forename: Margareth
authors.initials: M
authors.lastname: Brown
authors.forename: Uri
authors.initials: U
authors.lastname: Martinowitz
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Cohn
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000187:drug effects*; D015942:Factor VIIa / Q000627:therapeutic use*; D008099:Liver / Q000293:injuries; D010865:Pilot Projects; D011517:Prothrombin Time; D011897:Random Allocation; D011994:Recombinant Proteins / Q000627:therapeutic use; D012771:Shock, Hemorrhagic / Q000188:drug therapy* / Q000503:physiopathology*; D013552:Swine; D013997:Time Factors
chemical_list: D011994:Recombinant Proteins; D015942:Factor VIIa