Recombinant activated factor VII as treatment for intractable haemorrhage

The objective of this study was to determine the outcome of patients treated with recombinant activated factor VII (rFVIIa) to promote haemostasis in intractable bleeding associated with trauma injury or other causes. The medical records of 44 consecutive patients treated with rFVIIa were retrospectively reviewed for blood product use before and after treatment. A statistically significant decrease in blood product transfusion was evident in 23 trauma patients and 21 patients with other causes of bleeding who survived more than 4 hours after rFVIIa infusion. Although 10/23 trauma patients and 12/21 other causes patients died, between 2 and 50 days after rFVIIa infusion, these deaths were due to causes other than haemorrhage. The early use of rFVIIa was associated with decreased 50-day mortality in patients with severe trauma requiring massive transfusion, but was not associated with increased risk of severe thrombotic events.