The role of recombinant-activated factor VII in bleeding trauma patients.
OBJECTIVE
Exsanguinating hemorrhage and postshock organ failure account for 35-40% of deaths from trauma, and there is an increasing recognition of the importance of coagulopathy in the evolution of this disease.


RESULTS
Since 1999, case reports, small series, retrospective studies and a few controlled trials have reported the use of recombinant-activated factor VII (rFVIIa) as an adjunct for reversal of coagulopathy in trauma patients, and numerous other publications have examined the use of rFVIIa in related conditions such as traumatic brain injury, hemorrhagic stroke and uncontrolled surgical bleeding.


CONCLUSIONS
We present a brief discussion of the mechanism of action of rFVIIa and its role in facilitating hemostasis and a review of the recent medical literature on the use of rFVIIa in trauma patients, including current guidelines and controversies.
Dutton
Richard P
RP
Department of Anesthesiology, University of Maryland School of Medicine, Division of Anesthesiology, R. Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore, Maryland 21201, USA.
Conti
Bianca M
BM
D001778:Blood Coagulation Disorders / Q000188:drug therapy; D015942:Factor VIIa / Q000627:therapeutic use*; D017408:Guidelines as Topic; D006470:Hemorrhage / Q000188:drug therapy*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000188:drug therapy; D011994:Recombinant Proteins / Q000627:therapeutic use; D014947:Wounds and Injuries / Q000150:complications*
D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa