Minerva Anestesiol. 2005 Jun;71(6):281-9.

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15886589

Therapeutic approaches in trauma-induced coagulopathy.

Spivey M, Parr MJ.

Intensive Care Unit, Liverpool Hospital,University of New South Wales, Sydney, Australia.

Coagulopathy is a phenomenon which is a life threatening complication in the trauma patient who has sustained significant injuries and blood loss. With our increasing understanding of the mechanisms which drive the coagulopathy and the availability of new treatment options, most notably recombinant factor VIIa (rFVIIa), we are now able to treat those patients who have had a massive traumatic haemorrhage with greater efficacy. This paper reviews the current considerations in dealing with patients with trauma-induced coagulopathy and offers a strategy for their management.

PMID: 15886589 [PubMed - in process]

The Hospital Liaison Committee of Las Vegas has promoted the use of rFVIIa to several surgeons and a recent case involved a patient who, after surgery began to vomit violently rupturing four tied off veins. We were told that it would not work in this case. Yet after more discussion the Hemotologist ordered rFVIIa for the patient and she went home a few days later without further surgery. Jim Laws - Las Vegas HLC

At $5,000.00 a pop, this product needs judicious monitoring. It's great if it can save a life. For trauma and other urgent situations, yes. but hospitals can eat a lot of dollars really fast. Without FDA approval and no way to line-item bill in a lot of other cases, it needs to really be justified.

Just a thought.

__________________
Jo Valenti, RN
CBMS
Kennedy Health System