Modulation of the coagulation cascade using recombinant factor VIIa and activated protein C in a severely injured trauma patient

Exsanguination after trauma remains a leading cause of early death in severely injured patients [1]. Sepsis and multiple organ failure are significant causes of mortality in severely injured trauma patients who survive their injury and require a prolonged ICU hospitalization [2]. Despite advances in operative technique and critical care medicine, the treatment options for patients with coagulopathic hemorrhage or severe sepsis have remained relatively unchanged. We report a unique case in which pharmacological modulators of coagulation, recombinant Factor VIIa, and activated protein C were successfully used to treat massive hemorr-hage and then severe sepsis in a severely injured trauma patient.