Hemorrhage and Recombinant Factor VIIa A Brief Review

In spite of advances in trauma care, hemostasis remains a challenging problem in injured patients and uncontrolled hemorrhage is still a significant cause for morbidity and mortality. Recombinant factor VIIa (rFVIIa), initially used to treat hemophilia A or B in patients who have inhibitors to factor VIII or IX, is now a treatment option for hemorrhage in many different patient populations. On the basis of the mechanism of action, rFVIIa is an exciting alternative for hemostasis but not all studies have proven a significant benefit. This article reviews the general pathophysiology of coagulopathy secondary to trauma and acute resuscitation and some of the off-label indications for rFVIIa use.