Please use this identifier to cite or link to this item: https://doi.org/10.1159/000338034
Title: Use of activated recombinant factor VII in severe bleeding - Evidence for efficacy and safety in trauma, postpartum hemorrhage, cardiac surgery, and gastrointestinal bleeding
Authors: Iau, P.
Ong, V.
Tan, W.T.
Koh, P.L.
Hartman, M. 
Keywords: Bleeding complication
Coagulation factors
Factor VII
Issue Date: Apr-2012
Source: Iau, P., Ong, V., Tan, W.T., Koh, P.L., Hartman, M. (2012-04). Use of activated recombinant factor VII in severe bleeding - Evidence for efficacy and safety in trauma, postpartum hemorrhage, cardiac surgery, and gastrointestinal bleeding. Transfusion Medicine and Hemotherapy 39 (2) : 139-150. ScholarBank@NUS Repository. https://doi.org/10.1159/000338034
Abstract: Background: Uncontrolled bleeding continues to be a major cause of mortality in trauma, cardiac surgery, postpartum hemorrhage and liver failure. The aim of this paper is to assess the evidence supporting the efficacy of activated recombinant factor VII (rFVIIa) administration in these settings. Methods: Electronic literature search. Results: Numerous retrospective trials have mostly shown a decrease in blood transfusion requirements with no increase in thromboembolic events (TEE), but major limitations in trial design make generalization difficult. In most retrospective reports rFVIIa has been administered as a last-ditch attempt to control bleeding, when acidosis, hypothermia and coagulation factor depletion may not allow optimal rFVIIa effect. Prospective randomized controlled trials have not shown any effect of rFVIIa on mortality or TEE, although some have shown a reduction in RBC requirement. Conclusion: Stipulated transfusion protocols in prospective trials have reduced anticipated mortality among controls and make future trials for mortality effect unlikely in view of large sample size requirements. Establishment of these protocols and rapid hemostasis are likely to have greater benefits than administration of a single agent. Copyright © 2012 S. Karger AG, Basel.
Source Title: Transfusion Medicine and Hemotherapy
URI: http://scholarbank.nus.edu.sg/handle/10635/109081
ISSN: 16603796
DOI: 10.1159/000338034
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