Haemorrhage is a potential complication of any surgical procedure, presenting a major challenge to the surgeon and anaesthetist. In addition, uncontrolled bleeding accounts for at least 40% of the mortality associated with military and civilian trauma. Despite the widespread availability of standard interventions for the control of bleeding in such circumstances, there still remains an urgent need for an effective haemostatic agent that is safe, easy to use, and able to enhance local thrombotic processes without causing generalised arterial or venous thrombosis. Recombinant factor VIIa (rFVIIa; NovoSeven) has been successfully used in the management of haemophilia patients with inhibitors for many years. This review will explore its use in the control of surgery- and trauma-associated haemorrhage in patients without pre-existing coagulopathy, and will highlight the growing realisation that rFVIIa may have a major role not only as a treatment for haemophilia, but also as a universal haemostatic agent. This paper will also briefly explore those unanswered questions that should be resolved by future trials aiming to further clarify the safety, efficacy, and optimal dosing strategies of rFVIIa in the surgical and trauma settings.

中文翻译：

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重组因子VIIa（rFVIIa）及其在手术和创伤中的严重出血中的应用：综述。

出血是任何外科手术的潜在并发症，给外科医生和麻醉师带来了重大挑战。另外，失控的出血至少占与军事和平民创伤相关的死亡率的40％。尽管在这种情况下用于控制出血的标准干预措施已得到广泛应用，但仍迫切需要一种安全，易于使用并能够增强局部血栓形成过程而不会引起全身性动脉或静脉血栓形成的有效止血剂。重组因子VIIa（rFVIIa； NovoSeven）多年来已成功用于具有抑制剂的血友病患者的治疗。这篇评论将探讨其在不存在凝血病的患者中控制与手术和创伤有关的出血的用途，并将突出表明人们日益认识到，rFVIIa不仅可以作为血友病的治疗方法，而且可以作为通用止血剂发挥重要作用。本文还将简要探讨那些尚未解决的问题，这些问题应在以后的试验中解决，以进一步阐明rFVIIa在外科和创伤环境中的安全性，疗效和最佳剂量策略。