title: Hemostatic agents for bleeding: recombinant-activated factor VII and beyond.
abstract: A rapid restoration of hemostasis should be regarded as a primary goal for management of critical bleeding, which often represents a life-threatening condition. Among the various therapeutic strategies available in this clinical setting, we aim to summarize in this narrative review the current status on the use of recombinant-activated factor VII and prothrombin complex concentrates. The safety and effectiveness of these hemostatic agents in reversal of the anticoagulant effects of vitamin K antagonists will be also explored. In addition, their role in the management of acute bleeding associated with the newer direct oral anticoagulants dabigatran, rivaroxaban, and apixaban will be analyzed in a dedicated section.
authors.affiliation: Department of Hematology and Transfusion Medicine, Azienda Ospedaliera Carlo Poma, Mantova, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Franchini
authors.affiliation: Department of Hematology and Transfusion Medicine, Azienda Ospedaliera Carlo Poma, Mantova, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Crestani
authors.affiliation: Department of Hematology and Transfusion Medicine, Azienda Ospedaliera Carlo Poma, Mantova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Frattini
authors.affiliation: Department of Hematology and Transfusion Medicine, Azienda Ospedaliera Carlo Poma, Mantova, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Sissa
authors.affiliation: Department of Hematology and Transfusion Medicine, Azienda Ospedaliera Carlo Poma, Mantova, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Bonfanti
mesh_terms: D000284:Administration, Oral; D000818:Animals; D000925:Anticoagulants / Q000627:therapeutic use; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D015942:Factor VIIa / Q000627:therapeutic use*; D006470:Hemorrhage / Q000188:drug therapy*; D006487:Hemostasis; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D011516:Prothrombin / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D014812:Vitamin K / Q000037:antagonists & inhibitors
chemical_list: D000925:Anticoagulants; D001779:Blood Coagulation Factors; D006490:Hemostatics; D011994:Recombinant Proteins; D014812:Vitamin K; C025667:prothrombin complex concentrates; D011516:Prothrombin; C103587:recombinant FVIIa; D015942:Factor VIIa