Pharmacological Agents and Recombinant Activated Factor Viia

In the light of the concerns about blood safety, new data on the efficacy and safety of many of the pharmacological agents has highlighted their potential roles in managing bleeding. Pharmacological agents are used in two ways: either to prevent excessive bleeding or to treat established bleeding. The agents used can be broadly classified into four groups: antifibrinolytics, topical sealants, desmopressin and the recombinant prohaemostatic factors such as recombinant activated factor VIIa (rFVIIa). Findings from recent large randomized controlled trials (RCTs) have now clarified that tranexamic acid reduces mortality in bleeding trauma patients without adverse effects. Concerns remain about the extent of the efficacy and safety of rFVIIa, reiterating the central importance of RCTs to establish the effectiveness and safety of new interventions in transfusion medicine. This edition first published 2013 © 2001, 2005, 2009, 2013 John Wiley & Sons Ltd.