Clinical experiences and current evidence for therapeutic recombinant factor VIIa treatment in nontrauma settings.
The hemostatic properties of recombinant activated factor VII (rFVIIa) are established in patients with inherited or acquired hemophilia with inhibitors and in patients with congenital factor VII deficiencies. Emerging clinical evidence suggests that there may be a wider role for rFVIIa in the management of hemorrhage associated with traumatic injury/accident and severe bleeding associated with critical surgery. This article considers recent data from studies in which rFVIIa was used in an attempt to control bleeding in clinical situations as diverse as coagulopathy associated with chronic liver disease, massive perioperative bleeding and bleeding during prostatectomy, organ transplantation and orthopedic surgery, uncontrollable obstetric hemorrhage, and intracerebral hemorrhage. In nontrauma settings involving acute and potentially life threatening bleeding, there may be a place for rFVIIa as adjunctive therapy in the control of hemostasis.
Grounds
R Michael
RM
Adult Intensive Care Unit, St George's Hospital, London, UK. m.grounds@blueyonder.co.uk
Bolan
Charles
C
D000925:Anticoagulants / Q000009:adverse effects / Q000037:antagonists & inhibitors; D005167:Factor VII / Q000627:therapeutic use*; D015942:Factor VIIa; D006467:Hemophilia A / Q000188:drug therapy*; D006470:Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D016031:Liver Transplantation; D011183:Postoperative Complications / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000627:therapeutic use; D014859:Warfarin / Q000009:adverse effects / Q000037:antagonists & inhibitors
D000925:Anticoagulants; D011994:Recombinant Proteins; D014859:Warfarin; D005167:Factor VII; C103587:recombinant FVIIa; D015942:Factor VIIa