The hazard of comparing apples and oranges: The proper indication for the use of recombinant activated clotting factor VII in cardiac surgery

摘要

We read with interest the article by Uber and colleagues regarding the use of recombinant activated clotting factor VII (rFVIIa) after complex cardiovascular surgery and would like to raise the following issues. First, in our opinion it is inappropriate to compare the pharmacologic management of bleeding with surgical reexploration, especially when the origin of the bleeding is unknown. Postoperative bleeding is a common complication after cardiac surgery and a major cause of reexploration. Bleeding after cardiac surgery has 2 principle causes: multifactorial coa-gulopathy and surgical bleeding, each accounting for about 50% of cases.