Evidence-based Emergency Medicine/Critically Appraised Topic. The efficacy of recombinant activated factor VII in severe trauma.

Abstract

STUDY OBJECTIVE:

The use of recombinant activated factor VII (rFVIIa) in severe trauma is controversial. This evidence-based emergency medicine review evaluates the existing evidence about the efficacy and safety of rFVIIa for the management of severe trauma.

METHODS:

We searched MEDLINE, EMBASE, the Cochrane Library, and other databases. We limited our review to prospective, controlled trials that involved the therapeutic use of rFVIIa in the emergency department phase of care. We included studies with blunt and penetrating severe trauma. The primary outcome measure of interest was mortality. Secondary patient-important outcome measures included neurologic outcome, delayed surgical intervention, and adverse effects. Standard criteria were used to evaluate the quality of published trials.

RESULTS:

One randomized, blinded trial met the inclusion criteria. There was no significant difference in mortality or adverse effects between rFVIIa and placebo. Our other selected secondary outcome measures of interest were not reported.

CONCLUSION:

Existing evidence suggests that there is no significant difference in mortality between rFVIIa and placebo. Further research is needed to better understand the efficacy and safety of rFVIIa in patients with severe trauma.

• Authors: Daniel K Nishijima, Shahriar Zehtabchi
• Journal: Annals of emergency medicine (Ann Emerg Med) Vol. 54 Issue 5 Pg. 737-744.e1 (Nov 2009) ISSN: 1097-6760 [Electronic] United States
• PMID: 19285753 (Publication Type: Journal Article, Review)

Chemical References

• Coagulants
• Recombinant Proteins
• recombinant FVIIa
• Factor VIIa

Topics

• Blood Loss, Surgical (mortality, prevention & control)
• Coagulants (adverse effects, therapeutic use)
• Dose-Response Relationship, Drug
• Double-Blind Method
• Drug Administration Schedule
• Emergency Service, Hospital
• Evidence-Based Emergency Medicine
• Factor VIIa (adverse effects, therapeutic use)
• Female
• Hemorrhage (drug therapy, mortality, prevention & control)
• Humans
• Injury Severity Score
• Male
• Multiple Trauma (drug therapy, mortality, therapy)
• Prognosis
• Randomized Controlled Trials as Topic
• Recombinant Proteins (adverse effects, therapeutic use)
• Risk Assessment
• Survival Analysis
• Treatment Outcome