The Potential Role of Recombinant Activated Factor VIIa (rFVIIa) in Military Pre-Hospital Setting

Hemorrhage is a major cause of death of combat casualties in the battlefield. Coagulopathy may develop soon after trauma and plays an important role in the development of uncontrolled bleeding. Thus, introduction of potent hemostatic agents that can overcome the complex coagulopathy of trauma may de...

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Bibliographic Details
Main Authors: Martinowitz, Uri, Blumenfeld, Amir, Zaarur, Menashe, Bar-Lavie, Yaron, Levy, Yeheskel, Martonovits, Giora
Format: Report
Language:English
Subjects:
Anatomy and Physiology
Biochemistry
BLOOD CHEMISTRY
BLOOD COAGULATION
COMBAT AREAS
DEATH
EMERGENCY MEDICINE
FIRST AID
FOREIGN REPORTS
HEMORRHAGE
HEMORRHAGIC-INDUCED MORTALITY
HEMOSTASIS
HEMOSTATIC AGENTS
HYPOTHERMIA
Medicine and Medical Research
MORTALITY RATE
NATO FURNISHED
RECOMBINANT FACTOR VIIA
RFVIIA
TISSUE FACTOR
TRAUMA
TRAUMA-RELATED COAGULOPATHY
WOUNDS AND INJURIES
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Summary:Hemorrhage is a major cause of death of combat casualties in the battlefield. Coagulopathy may develop soon after trauma and plays an important role in the development of uncontrolled bleeding. Thus, introduction of potent hemostatic agents that can overcome the complex coagulopathy of trauma may decrease mortality from exsanguinations. Recombinant factor VIIa (rFVIIa) has been shown to overcome a variety of coagulation and platelet disorders including trauma-related coagulopathy. Controlled animal trials, small case series and anecdotal case reports have suggested that the use of rFVIIa may slow down and even control massive bleeding in trauma and hence prolong survival and reduce mortality. In most cases rFVIIa was used as an adjunct treatment to surgical hemostasis. However, in some, cessation of bleeding with reduction of early mortality was achieved by administration of rFVIIa alone. The accumulating efficacy data together with the high safety of rFVIIa suggest that fielding of rFVIIa to the combat setting should be considered with the aim of widening the survival window of exsanguinating casualties. As controlled trials in the combat setting are not feasible further assessments will have to be based on data from civilian trauma. Presented at the RTO HFM Symposium on Combat Casualty Care in Ground Based Tactical Situations: Trauma Technology and Emergency Medical Procedures, held in St. Pete Beach, FL on 16-18 August 2004. Published in RTO-MP-HFM-109. See also ADM001795, Combat Casualty Care in Ground-Based Tactical Situations: Trauma Technology and Emergency Medical Procedures.