Hemostatic agents for bleeding: recombinant-activated factor VII and beyond.

ABSTRACT

A rapid restoration of hemostasis should be regarded as a primary goal for management of critical bleeding, which often represents a life-threatening condition. Among the various therapeutic strategies available in this clinical setting, we aim to summarize in this narrative review the current status on the use of recombinant-activated factor VII and prothrombin complex concentrates. The safety and effectiveness of these hemostatic agents in reversal of the anticoagulant effects of vitamin K antagonists will be also explored. In addition, their role in the management of acute bleeding associated with the newer direct oral anticoagulants dabigatran, rivaroxaban, and apixaban will be analyzed in a dedicated section.