Procoagulant agents
Five studies reported on the relation between MOF and the use of procoagulant agents in patients with severe hemorrhage. In an RCT with 573 patients, recombinant factor VII (rVII) significantly reduced transfusion requirements in both blunt and penetrating trauma patients and showed a trend toward a lower MOF rate in blunt trauma patients (60). Another RCT showed a lower incidence of MOF in patients treated with rVII, although these results were not significant (58). Pooling of data from these two RCTs suggested a lower incidence of MOF in patients treated with rVII compared to placebo (RR 0.81, 95% CI 0.68–0.98, Figure Figure44).