A clinical review of bleeding dilemmas in trauma

Trauma is rapidly replacing stroke and cardiovascular disease as a leading cause of death in Western countries such as the United States, and almost a third (30%) of trauma deaths are due to blood loss. Although the new intervention strategies that have been developed and adopted by emergency care staff have reduced this mortality in recent years, bleeding continues to be a major challenge in the management of trauma patients. This paper reviews recent developments and controversies in trauma care, and, in particular, the potential role of procoagulant therapy using recombinant factor VIIa in the prevention of mortality due to bleeding.