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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Pro/Con Debate: Does recombinant factor VIIa have a role to play in the treatment of patients with acute nontraumatic hemorrhage? | Available online http ccforum.eom content 10 3 214 Review Pro Con Debate Does recombinant factor Vila have a role to play in the treatment of patients with acute nontraumatic hemorrhage Paola Pieri1 Deborah M Stein1 Sandro Scarpelini2 and Sandro Rizoli3 1 Division of Critical Care Program in Trauma R Adams Cowley Shock Trauma Center University of Maryland School of Medicine Baltimore Maryland USA 2Trauma and Emergency Surgery Faculty of Medicine of Ribeirão Preto University of Sao Paulo Brazil 3Sunnybrook Health Sciences Centre University of Toronto Toronto Canada Corresponding author Sandro Rizoli sandro.rizoli@sw.ca Published 1 June 2006 This article is online at http ccforum.com content 10 3 214 2006 BioMed Central Ltd Critical Care 2006 10 214 doi 10.1186 cc4940 Abstract Perhaps it is not surprising that in the critical care environment where lives are frequently on the line off-label use of certain drugs is relatively common. In general there are two camps of opinion on this type of utilization. One camp would suggest that potentially life saving products cannot ethically be withheld from patients who may benefit. The other camp would counter that it is inappropriate to administer products if the risk benefit ratio has not been clearly defined in clinical trials. Off-label use of factor VII is debated in this issue of Critical Care for a patient with uncontrolled nontraumatic hemorrhage. Perhaps this product promotes additional discussion given that its ability to control bleeding can be dramatic yet its costs and potential for complications high. The scenario A 49-year-old male has been managed in the intensive care unit for 5 days after a large left diaphragmatic hernia repair and is currently being weaned from mechanical ventilation. He suddenly has significant hematemesis and becomes hemodynamically unstable with alteration to his coagulation. You start to resuscitate him with fluid blood and plasma in order to reverse the hemorrhagic shock and correct the
