[Rational treatment of uncontrollable, life-threatening hemorrhage with recombinant factor VIIa].

We present a standardised treatment algorithm used to treat life-threatening haemorrhage (LTH) due to trauma, surgery, or delivery at Rigshospitalet, Copenhagen University Hospital. Balanced transfusion therapy and infusion of fibrinogen must precede recombinant factor VIIa (rFVIIa) treatment. rFVIIa is indicated in patients with uncontrollable LTH ( > 1 blood component per 10 kg of whole body weight per hour) despite surgical treatment and adequately balanced transfusion. We recommend rFVIIa at a dose of 100 microg/kg. The dosage recommendation is not evidence-based. A thorough, prospective surveillance program to monitor the treatment's efficacy and safety is therefore mandatory. The Blood Bank services, guides and coordinates the treatment.