Early rFVIIa Reduces RBC Needs in Trauma Patients Who Receive Massive Transfusion

Massive transfusion leads to hypothermia and dilution of coagulation proteins, causing or exacerbating coagulopathy. This effect correlates with the amount of blood transfused. To determine whether mortality is reduced when recombinant factor VIIa (rFVIIa) is given early (before transfusion of 8 units of blood) rather than late (after transfusion of >8 units), researchers retrospectively reviewed patient records at combat hospitals in Iraq during 2004 and 2005.

Of 5334 trauma patients, 365 received massive transfusion (≥10 units of red blood cells [RBCs] in 24 hours), and 117 of those (32%) received rFVIIa. Of the 61 patients who received rFVIIa and had complete records (90% had penetrating trauma; mean age, 23), 17 received early rFVIIa and…