Transfus Apher Sci
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Massive transfusion is a consequence of uncontrolled bleeding. It taxes the resources of both hospital and physicians. It occurs most commonly in trauma, cardiac and vascular surgery and less frequently in obstetrics. ⋯ The protocol was developed with the input from transfusion medicine, trauma surgery, emergency and ICU and anaesthesia. The protocol is distributed with the 7th unit of blood issued and is a reminder of the principles. Results are tracked and may lead to modifications in the protocol.
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Children and adolescents comprise a significant proportion of the hemophilia population, including those patients who have developed inhibitors to factor VIII or FIX. We examine the use of rFVIIa for the treatment of bleeding episodes and the prevention of bleeding in children and adolescents with hemophilia A and B with inhibitors, focusing on registry data and recent clinical trial results. Based on this review of the literature, we conclude that recombinant FVIIa is safe and effective for use in controlling bleeding in these patient populations.