Richard P Dutton1, Bianca M Conti. 1. 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.
Abstract
PURPOSE OF REVIEW: 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. RECENT FINDINGS: 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. SUMMARY: 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.
PURPOSE OF REVIEW: 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. RECENT FINDINGS: 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 traumapatients, and numerous other publications have examined the use of rFVIIa in related conditions such as traumatic brain injury, hemorrhagic stroke and uncontrolled surgical bleeding. SUMMARY: 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 traumapatients, including current guidelines and controversies.
Authors: Heiko Lier; Bernd W Böttiger; Jochen Hinkelbein; Henning Krep; Michael Bernhard Journal: Intensive Care Med Date: 2011-02-12 Impact factor: 17.440