San Diego State University, School of Social Work, San Diego, USA.
Emerg Med J. 2010 Feb;27(2):121-4. doi: 10.1136/emj.2008.060657.
Recombinant activated human coagulation factor VII (rFVIIa), an intravascular strategy to promote clotting, is being used as an adjunct to surgical control of bleeding in combat trauma patients.
To describe the initial experiences with rFVIIa administered to combat casualties at US Navy-Marine Corps medical treatment facilities in Iraq, and to compare survival outcomes of those treated with rFVIIa to controls not receiving rFVIIa.
Medical encounter data from the US Navy-Marine Corps Combat Trauma Registry were retrospectively reviewed to identify all battle-injured patients documented as having received rFVIIa during the period May 2004 to January 2006 of Operation Iraqi Freedom. Available clinical and injury related data are presented to characterise the patients. To assess effects of rFVIIa on survival outcomes, rFVIIa cases were matched to controls on injury severity and age.
22 battle-injured patients from the Combat Trauma Registry received rFVIIa. Primarily young US Marines, these patients typically had penetrating injuries from improvised explosive devices and gunshot wounds. Injuries were often abdominal. The average dose used was similar to that reported in another study of civilian trauma patients, although dosing varies widely in the existing experimental and anecdotal literature. Over two-thirds (68%) of the rFVIIa patients survived-an identical outcome seen for a matched control group of 22 patients.
Survival of seriously injured combat casualties was good, although identical to that of a control group. Methodological limitations of this retrospective study preclude making firm conclusions about the effectiveness of rFVIIa. Future controlled studies are needed for safety and efficacy testing of rFVIIa in combat trauma patients.
重组活化人凝血因子 VII（rFVIIa）是一种促进凝血的血管内策略，正被用作控制战场创伤患者出血的手术辅助手段。
描述在美国海军陆战队医疗设施中对战场伤员使用 rFVIIa 的初步经验，并将接受 rFVIIa 治疗的患者与未接受 rFVIIa 治疗的对照组的生存结果进行比较。
回顾性审查美国海军陆战队战伤登记处的医疗接触数据，以确定在 2004 年 5 月至 2006 年 1 月伊拉克自由行动期间记录有接受 rFVIIa 治疗的所有战斗受伤患者。提供了现有的临床和损伤相关数据，以描述患者。为了评估 rFVIIa 对生存结果的影响，根据损伤严重程度和年龄对 rFVIIa 病例和对照组进行匹配。
战伤登记处的 22 名战场受伤患者接受了 rFVIIa 治疗。这些患者主要是年轻的美国海军陆战队员，他们通常受到简易爆炸装置和枪伤的穿透性损伤。损伤通常在腹部。使用的平均剂量与另一项平民创伤患者研究报告的剂量相似，尽管在现有的实验和轶事文献中剂量差异很大。超过三分之二（68%）的 rFVIIa 患者存活-与 22 名匹配的对照组患者的结果相同。
严重受伤的战场伤员的存活率较高，尽管与对照组相同。这项回顾性研究的方法学局限性使得无法对 rFVIIa 的有效性做出明确结论。需要进行未来的对照研究，以测试 rFVIIa 在战场创伤患者中的安全性和有效性。
