'Last-ditch' use of recombinant factor VIIa in patients with massive haemorrhage is ineffective.
OBJECTIVE
The aim of this retrospective study was to assess the effect of activated recombinant factor VII (rFVIIa) on the natural history of massive transfusion episodes.


METHODS
During 2002, outcome parameters were assessed in 50 patients transfused with more than 10 units of packed red cells. The effect of the addition of rFVIIa in 10 patients, with intractable bleeding, was then observed.


RESULTS
Overall mortality was 20% at 24 h and 34% at 7 days. Severe coagulopathy was confirmed as a serious negative prognostic factor and occurred in 42% of patients overall, but in 70% of rFVIIa-treated patients. Transient cessation or reduction of bleeding was noted in 60% of patients following rFVIIa infusion. However, 24-h and 7-day mortality rates were 40% and 70%, respectively, in this group.


CONCLUSIONS
Last-ditch rFVIIa therapy in patients resistant to conventional treatment did not rescue these patients or significantly alter outcomes.
Clark
A D
AD
Haematology Department, Glasgow Royal Infirmary, Glasgow, UK. campbell.tait@nothglasgow.scot.nhs.uk
Gordon
W C
WC
Walker
I D
ID
Tait
R C
RC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001019:Aortic Rupture / Q000150:complications / Q000401:mortality; D001771:Blood Banks / Q000706:statistics & numerical data; D001778:Blood Coagulation Disorders / Q000150:complications; D017707:Erythrocyte Transfusion; D005167:Factor VII / Q000627:therapeutic use*; D015942:Factor VIIa; D005260:Female; D006470:Hemorrhage / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000188:drug therapy / Q000401:mortality; D011994:Recombinant Proteins / Q000627:therapeutic use*; D016879:Salvage Therapy; D017211:Treatment Failure; D014947:Wounds and Injuries / Q000150:complications
D011994:Recombinant Proteins; D005167:Factor VII; C103587:recombinant FVIIa; D015942:Factor VIIa