Recombinant factor VIIa for control of hemorrhage: early experience in critically ill trauma patients.

Abstract

STUDY OBJECTIVE:

To examine our institutional experience with recombinant Factor VIIa (rFVIIa) as a treatment for exsanguinating hemorrhage in critically ill trauma patients.

DESIGN:

Retrospective case review.

SETTING:

A specialized trauma and critical care hospital, serving as the quaternary referral center for trauma and surgical shock in the state of Maryland.

PATIENTS:

All patients with diffuse coagulopathy and impending exsanguination, given rFVIIa in an effort to control life-threatening hemorrhage. Patients were in the intensive care unit (ICU) or operating room (OR) and included both acute admissions and late-stage patients with multiple organ system failure.

INTERVENTIONS:

Patients of interest were those that had received rFVIIa.

MEASUREMENTS:

Examination of medical records, including pharmacy data, laboratory results, and the institutional trauma registry.

MAIN RESULTS:

Administration of rFVIIa contributed to successful control of hemorrhage in three of five patients. Failure in two patients was mostly likely due to overwhelming shock and acidosis.

CONCLUSIONS:

Administration of rFVIIa shows promise in the treatment of exsanguinating hemorrhage. Prospective, controlled clinical trials of this therapy are strongly recommended.

• Authors: Richard P Dutton, John R Hess, Thomas M Scalea
• Journal: Journal of clinical anesthesia (J Clin Anesth) Vol. 15 Issue 3 Pg. 184-8 (May 2003) ISSN: 0952-8180 [Print] United States
• PMID: 12770653 (Publication Type: Case Reports, Journal Article)

Chemical References

• Recombinant Proteins
• Factor VIIa

Topics

• Abdominal Injuries (therapy)
• Accidental Falls
• Acidosis (physiopathology)
• Adult
• Blood Coagulation Disorders (etiology)
• Critical Care
• Factor VIIa (therapeutic use)
• Fatal Outcome
• Female
• Hemodynamics (drug effects, physiology)
• Hemorrhage (complications, drug therapy, etiology)
• Humans
• Intensive Care Units
• Male
• Multiple Organ Failure (therapy)
• Operating Rooms
• Pregnancy
• Recombinant Proteins (therapeutic use)
• Retrospective Studies
• Shock (physiopathology, therapy)
• Wounds and Injuries (physiopathology, therapy)
• Wounds, Gunshot (therapy)