Abstract
This article at first explained pharmacological action, clinical use for hemophilia with inhibitor or acquired inhibitor of blood coagulation, and side effects of recombinant activated factor VII (rFVIIa) based on a cell-based model of hemostasis. And then we reviewed off-label use of rFVIIa in various types of uncontrolled bleeding. Massive uncontrolled bleeding is an important cause of morbidity and mortality, and every attempt should be made to control bleeding by conventional means before considering a trial of rFVIIa. rFVIIa is now used to control bleeding in blunt trauma patients, postoperative bleeding after cardiac surgery, surgical bleeding, life-threatening post-partum hemorrhage, and acute intracerebral hemorrhage. However, rFVIIa is not currently recommended for use in the management of uncontrolled bleeding associated with penetrating trauma, elective surgery, liver surgery, and bleeding in patients with liver cirrhosis. rFVIIa efficacy should be monitored visually and by assessing transfusion requirement. rFVIIa appears to be relatively safe with rare incidence of thromboembolic adverse events, however, the events after use of rFVIIa should be carefully monitored.
