title: "Low-dose" recombinant activated factor VII results in less blood and blood product use in traumatic hemorrhage.
abstract: BACKGROUND
  This study was designed to compare mortality and blood product use in patients who received recombinant activated factor VII (rFVIIa) for traumatic hemorrhage to a matched historic control.
  
  
  METHODS
  Trauma registry data of bleeding trauma patients who received rFVIIa (40 microg/kg, repeated once if needed) included 28-day mortality; pre- and post-rFVIIa international normalized ratio; and packed red blood cell (PRBC), fresh frozen plasma, platelet, and cryoprecipitate requirements. A control group was created of bleeding patients who did not receive rFVIIa by matching for Injury Severity Score and age. The chi2 and Student's t tests were used to test for significance.
  
  
  RESULTS
  Twenty-nine patients, well matched to 72 control patients, made up the rFVIIa group. rFVIIa corrected international normalized ratio within 4 hours (from 4.4 to 1.2; p < 0.0001). There was no difference in mortality (control, 40.3%; rFVIIa, 41.4%). The rFVIIa group required significantly fewer PRBC transfusions than the control group (18.3 +/- 7.5 vs. 22.0 +/- 9.7; p = 0.036). Compared with the control group, the rFVIIa group required fewer platelet transfusions (1.4 +/- 1.2 vs. 2.3 +/- 2.1; p = 0.01) and less cryoprecipitate (0.59 +/- 0.54 vs. 1.5 +/- 1.8; p = 0.006).
  
  
  CONCLUSIONS
  rFVIIa resulted in significantly less PRBC, platelet, and cryoprecipitate use and equivalent mortality when compared with the matched control group, with no increase in complications.
authors.affiliation: Department of Surgery, Lehigh Valley Hospital, Allentown, Pennsylvania 18105-1556, USA. sally.lutz@lvh.com
authors.forename: T Daniel
authors.initials: TD
authors.lastname: Harrison
authors.forename: Jason
authors.initials: J
authors.lastname: Laskosky
authors.forename: Omid
authors.initials: O
authors.lastname: Jazaeri
authors.forename: Michael D
authors.initials: MD
authors.lastname: Pasquale
authors.forename: Mark
authors.initials: M
authors.lastname: Cipolle
mesh_terms: D000328:Adult; D001803:Blood Transfusion / Q000706:statistics & numerical data; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005167:Factor VII / Q000627:therapeutic use*; D015942:Factor VIIa / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D015601:Injury Severity Score; D019934:International Normalized Ratio; D008297:Male; D011994:Recombinant Proteins / Q000627:therapeutic use; D012042:Registries; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications*
chemical_list: D011994:Recombinant Proteins; D005167:Factor VII; C103587:recombinant FVIIa; D015942:Factor VIIa