The role of recombinant factor VIIa in the treatment of life-threatening haemorrhage in blunt trauma.

Background: Recombinant factor VIIa (rFVIIa) is a novel haemostatic agent originally developed to treat bleeding in haemophiliacs. Several case reports suggest effectiveness of rFVIIa in the treatment of patients without pre-existing bleeding disorders. The aim of this study is to evaluate treatment with recombinant (rFVIIa) in blunt trauma patients with uncontrolled bleeding.

[A 'blind' transfusion policy in patients with acute severe blood loss].

Three patients presented with acute, excessive bleeding: a 54-year-old man following trauma to the pelvis, a 34-year-old woman with postpartum blood loss and a 62-year-old man with a duodenal ulcer. Treatment consisted of surgery, the administration of blood products and haemostatic agents, in varying strategies. The men recovered but the woman died as a result of cardiac rhythm disorders.

Percutaneous tracheostomy with the Blue Rhino trade mark technique: presentation of 100 consecutive patients.

We assessed the peri-operative, early and late complications in 100 percutaneous tracheostomies performed with the Blue Rhino trade mark kit. The success rate was 98%. Peri-operative complications occurred in 30 patients.

Bacteria in blood smears: overwhelming sepsis or trivial contamination.

It is unusual to find microorganisms in peripheral blood smears, and their presence is frequently associated with overwhelming sepsis and consequently a poor prognosis. In this report, we demonstrate 4 cases with bacteria in blood smears. Two of them had a fatal outcome, but the other 2 were caused by a contamination either via the central venous catheter or in vitro, both without dramatic outcome.