Abstract：Objective To evaluate the effect of recombinant activated factor Ⅶ (rⅦa) in treatment of hemorrhagic shock after severe multiple injuries with coagulopathy. Methods Sixteen cases of coagulopathy after severe multiple injuries administered with rⅦa between July 2011 and June 2012 were reviewed. The requirements of blood product and coagulogram variation were comparatively studied before and after rⅦa therapy. Results After rⅦa therapy, bleeding was brought to a halt in 24 hours for nine cases and in 72 hours for seven cases. In the end, 13 out of the 16 cases survived in the absence of myocardial infarct, cerebrovascular accident or deep vein thrombosis. Requirements of red blood cells, fresh frozen plasma, cryoprecipitate and platelet (PLT) were decreased at 48 hours after the final therapy as compared with those at 48 hours prior to the primary therapy, but statistical significance only existed in the reduction of fresh frozen plasma and cryoprecipitate (P＜0.05). The coagulogram indices including prothrombin time (PT) and activated partial thromboplastin time (APTT) at 4 hours after the final therapy presented statistical differences from those prior to the primary therapy (P＜0.05). Conclusion rⅦa is an important, effective and safe auxiliary means for surgical hemostasis of coagulopathy after severe multiple injuries.
HUANG Guang-bin,WANG Pan,HE Ping et al. Recombinant activated factor Ⅶ for coagulopathy in patients with severe multiple injuries[J]. CHINESE JOURNAL OF TRAUMA, 2013, 29(7): 588-590.
［2］Goudemand J. Recombinant activated factor VII: a new treatment for hemophilia. Transfus Clin Biol, 1998, 5(4):260-265.
［3］Holcomb JB, Wade CE, Michalek JE, et al. Increased plasma and platelet to red blood rations improves outcome in 446 massively transfused civilian trauma patients. Ann Surg, 2008, 248(3):447-458.
［4］Spinella PC. Warm fresh whole blood transfusion for severe hemorrhage: U.S. military and potential civilian application. Crit Care Med, 2008, 36 Suppl 7:S340-S345.
［5］Perkins JG, Schreiber MA, Wade CE, et al. Early versus late recombinant factor VIIa in combat trauma patients requiring massive transfusion. J Trauma, 2007, 62(5):1095-1099.
［6］Maclaren R, Weber LA, Brake H, et al. A multicenter assessment of recombinant factor VIIa off-label usage: clinical experiences and associated outcomes. Transfusion, 2005, 45(9):1434-1442.
［7］Knudson MM, Cohen MJ, Reidy R, et al. Trauma, transfusion, and use of recombinant factor VIIa: a multicenter registry report of 380 patients from the Western Trauma Association. J Am Coll Surg, 2011, 212(1):87-95.
［8］Mayer SA, Brun NC, Broderick J, et al. Recombinant activated factor VIIa for acute intracerebral hemorrhage: US phase IIA trial. Neurocrit Care, 2006, 4(3):206-214.
