Use of Recombinant Factor VIIa in Operation Iraqi Freedom and Operation Enduring Freedom: Survey of Army Surgeons

Military physicians are using recombinant factor VIIa (rFVIIa) in Iraq and Afghanistan to help stop life-threatening hemorrhage in trauma patients. We constructed a questionnaire and surveyed Army general surgeons deployed to Iraq and/or Afghanistan about their predeployment experience, deployment experience, and projected postdeployment practice regarding rFVIIa usage. Most surgeons had rFVIIa available during their deployment (65%). The drug was used with varying frequency and subjective therapeutic effect. A majority of surgeons (79%) were unaware of any guideline or policy governing the use of rFVIIa. Seventy percent of respondents would use the drug in their future practice. Deployed surgeons generally have positive attitudes regarding the use of rFVIIa, but greater guidance and outcome measures are needed.