Factor VII

A decrease in FVII activity significantly contributes to the coagulopathy and progressive hemorrhagic injury (PHI) in patients with isolated traumatic brain injury 1).

FVIIa and prothrombin complex concentrate (PCC) appear more effective than fresh frozen plasma (FFP).

Either FVIIa or PCC are reasonable options for reversal, but FVIIa is considerably more expensive and may have greater risk of INR rebound 2).

1)
Wu X, Du Z, Yu J, Sun Y, Pei B, Lu X, Tang Z, Yin M, Zhou L, Hu J. Activity of factor VII in patients with isolated blunt traumatic brain injury: association with coagulopathy and progressive hemorrhagic injury. J Trauma Acute Care Surg. 2014 Jan;76(1):114-20. doi: 10.1097/TA.0b013e3182a8fe48. PubMed PMID: 24368365.
2)
Woo CH, Patel N, Conell C, Rao VA, Faigeles BS, Patel MC, Pombra J, Akins PT, Axelrod YK, Ge IY, Sheridan WF, Flint AC. Rapid Warfarin Reversal in the Setting of Intracranial Hemorrhage: A Comparison of Plasma, Recombinant Activated Factor VII, and Prothrombin Complex Concentrate. World Neurosurg. 2014 Jan;81(1):110-115. doi: 10.1016/j.wneu.2012.12.002. Epub 2012 Dec 5. Review. PubMed PMID: 23220122.