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rFVIIa effective in massive uncontrolled bleeding

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Recombinant activated Factor VII may improve coagulation variables and reduce the amount of red blood cell and fresh-frozen plasma transfusions among patients with uncontrolled blood loss, according to data from a retrospective, observational analysis.

The study included 32 patients with massive uncontrolled blood loss who received rFVIIa from April 2004 to January 2008. The researchers extracted data from patient files, anesthesia reports, the electronic hospital information system and computer files of the hospital blood transfusion service.

Researchers compared transfusions before and up to 48 hours after infusion of rFVIIa and found that 32 patients with massive uncontrolled blood loss experienced a reduction in transfusion requirements after rFVIIa infusion. Mean red blood cell transfusions were reduced from 20.1 units prior to rFVIIa to 8.7 units after rFVIIa (95% CI, 6.4-16.5). Similarly, fresh-frozen plasma transfusions were reduced from 19.3 units before rFVIIa to 9.3 units after rFVIIa (95% CI, 4.2-15.6).

At discharge from the hospital, 56% of patients who received rFVIIa were alive.

Berkhof FF. Transfusion. 2009;49:570-577.