title: Effects of recombinant activated factor VIIa on abdominal trauma patients.
abstract: Recombinant activated factor VIIa (rFVIIa) has been highlighted by correcting uncontrollable traumatic haemorrhage. Compared with routine coagulation tests, thromboelastography (TEG) can evaluate the coagulation function of trauma patients more rapidly, accurately and comprehensively, and can also diagnose trauma-associated coagulopathy (TAC) in an early stage. Thirty-eight cases conforming to rFVIIa indications were screened according to TEG results and divided into an rFVIIa group (n = 20) and a nonrFVIIa group (n = 18). Their coagulopathy was goal-directedly corrected under the guidance of TEG. The parameters examined by routine coagulation tests and TEG were compared. The blood components transfused in the two groups were also calculated. When rFVIIa was administered by an average dose of 52.3 μg/kg (24.0-95.6 μg/kg), blood coagulation function was significantly improved in 48 h. Compared with the nonrFVIIa group, the treatment group experienced decreased R time. Moreover, significant fewer red blood cells, platelet and fresh frozen plasma were transfused in the rFVIIa group. All patients underwent daily bedside vascular ultrasound screening within a week after haemostatic treatment, of which no thromboembolic events occurred. TEG can sensitively detect TAC. rFVIIa administered goal-directedly guided by TEG is more effectively in correcting TAC and decreasing the amount of blood product transfusion.
authors.affiliation: Department of Surgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, P.R. China.
authors.forename: Danhua
authors.initials: D
authors.lastname: Yao
authors.forename: Yousheng
authors.initials: Y
authors.lastname: Li
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Wenkui
authors.initials: W
authors.lastname: Yu
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D000007:Abdominal Injuries / Q000097:blood / Q000188:drug therapy*; D000293:Adolescent; D000328:Adult; D001778:Blood Coagulation Disorders / Q000188:drug therapy; D015942:Factor VIIa / Q000008:administration & dosage*; D005260:Female; D006470:Hemorrhage / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage; D012189:Retrospective Studies; D013916:Thrombelastography / Q000379:methods; D055815:Young Adult
chemical_list: D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa