Early use of recombinant factor VIIa improves mean arterial pressure and may potentially decrease mortality in experimental hemorrhagic shock: a pilot study.
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.
Lynn
Mauricio
M
Division of Trauma and Surgical Critical Care, University of Miami School of Medicine, Miami, Florida 33101, USA.
Jerokhimov
Igor
I
Jewelewicz
Dory
D
Popkin
Charles
C
Johnson
Edward W
EW
Rashid
Qammar N
QN
Brown
Margareth
M
Martinowitz
Uri
U
Cohn
Stephen M
SM
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
D011994:Recombinant Proteins; D015942:Factor VIIa