GARY P. WRATTEN SURGICAL SYMPOSIUM The Clinical and Laboratory Response to Recombinant Factor VIIa in Trauma and Surgical Patients with Acquired Coagulopathy

RESULTS: Overall mortality was 39%. All but 1 patient (17/ 18) had resolution of coagulopathic bleeding with rFVIIa, and all clinical responders (n 17) (defined as clinical cessation of bleeding within 24 hours determined by either attending surgeon or chief resident progress note) had a decrease in PT to normal range. In contrast, the single clinical nonresponder had an insignificant PT decrease (19 to 18 seconds). Prothrombin time decreased from 20 4 seconds to 12 2 seconds, p 0.05 (n 17). International Normalized Ratio (INR) decreased from 1.59 to 0.86, p 0.05 (n 17). Fibrinogen before administration was 299.73 (range, 105-564) (n 15). pH before administration was 7.25 ( 0.18) (n 10). Patient temperature was 98.64 ( 2.06). Effect in partial thromboplastin time (PTT) was inconsistent (50 49 seconds to 34 6 seconds, p 0.05). Transfusion requirements for red blood cells (14 to 3 units) and plasma (12 to 3 units) were significantly reduced after rFVIIa. There were no significant differences in percentage PT decrease between dose 100 mcg/kg vs 100 mcg/kg, surgical vs trauma patients, survivors vs nonsurvivors, and those with pretreatment platelet count 100 K vs 100 K.