Issue 9 Spring 2007

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CRASH-2 Recruitment achievement – 5000 patients!

Congratulations to you all for continuing to work tirelessly for the success of your trial. By the time you receive this letter the trial will have recruited over 5000 patients. This is due purely to the hard work and dedication of all our collaborators. The recruitment plan made at the start of the trial is shown in the graph in red. As you can see (in blue) we have achieved consistently above this prediction. However, we have now hit the hardest phase and need to step up recruitment even more. Congratulations to you all again for achieving this important milestone!

Recruitment graph
World regions pie charts


What are the effects of administration of Recombinant factor VIIa for managing haemorrhage in patients without haemophilia?

Cochrane logo

Recombinant factor VIIa (rFVIIa) is increasingly being used off-license to prevent bleeding in operations where blood loss is likely to be high, and/or stopping bleeding that is proving difficult to control by other means. A new Cochrane Systematic Review1 examines the evidence from randomised controlled trials (RCTs) for the effects of such prophylactic and therapeutic use of rFVIIa in these indications. The authors found 13 placebo-controlled double-blind RCTs eligible for inclusion; six (n=724) examined the prophylactic use of rFVIIa and seven (n=1214) the therapeutic use. For both uses the data from the studies suggest there is no observed advantage or disadvantage of using rFVIIa over placebo that could not have been a result of chance alone.

The review concluded that whilst rFVIIa has a role in the management of patients with haemophilia, its effectiveness as a more general haemostatic drug remains uncertain. The use of rFVIIa outside its current licensed indications should be very limited and its wider use should await the results of ongoing and possibly newly commissioned RCTs. In the interim, rFVIIa use should be restricted to clinical trials.

The full text of the review can be accessed through The Cochrane Library ( For more information about the Cochrane Injuries Group and to access abstracts of other systematic reviews, please visit

1Stanworth SJ, Birchall J, Doree CJ, Hyde C. Recombinant factor VIIa for the prevention and treatment of bleeding in patients without haemophilia. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD005011. DOI: 10.1002/14651858.CD005011.pub2.

crash 2 around the world

KKUH team Saudi Arabia

Abdelazeem Eldawlatly and team in King Khalid University Hospital, Saudi Arabia
Rasananda Mangual and team in MKCG Medical College, India
MKCG team India
Castro Rendon team Argentina
Silvana Svampa and team in Hospital Castro Rendon, Argentina

Jorge Teves and team in Hospital ‘Dr Oscar Alende’, Argentina

Oscar Alende team Argentina

Care Hospital team India

P V Ramana and team in Care Hospital, India

new faces
Matthew Berle started as a Trial Assistant in April and will be working with the admin team preparing the trial materials.
Matthew Berle Juan Camilo Correa We welcome to the trial team Juan Camilo Correa, a 5th year medical student, who will be looking after all the data from Hospital Universitario San Vicente de Paul in Colombia.

first patient - Randomisation has started in the following centres:

  • Jorge Teves, Hospital Interzonal General de Agudos 'Dr Oscar Alende', Argentina
  • Jorge Balbi, Hospital Regional Rio Grande, Argentina
  • Ian Seppelt, Nepean Hospital, Australia
  • Irene Pastrana, Hospital Abel Santamaria Cuadrado, Cuba
  • Marjoris Piñera, Hospital Clínico-Quirúrgico Docente "Saturnino Lora", Cuba
  • Humberto Lezcano, Hospital General Universitario "Carlos Manuel De Cespedes”, Cuba
  • Eugenio Casola, Hospital Provincial Docente "Manuel Ascunce Domenech", Cuba
  • Aida Madrazo, Hospital Provincial Docente V I Lenin, Cuba
  • Mario Domínguez, Hospital Universitario "Arnaldo Milián Castro", Cuba
  • Marcos Iraola, Hospital Universitario "Dr Gustavo Aldereguia Lima", Cuba
  • Humberto Lezcano, Hospital General Universitario "Carlos Manuel de Cespedes”, Cuba
  • Daniel Acosta Farina, Hospital Alcivar, Ecuador
  • Suresh David, Christian Medical College Hospital, Vellore, India
  • Sharad Vyas, Civil Hospital, India
  • Rasananda Mangual, MKCG Medical College, India
  • Parag Sancheti, Sancheti Institute for Orthopaedics and Rehabilitation, India
  • Pankaj Patel, Sheth VS General Hospital and NHL Municipal College, India
  • Susilo Chandra, Cipto Mangunkusumo Hospital, Indonesia
  • Farhad Bal'afif, Saiful Anwar General Hospital, Indonesia
  • A O Durodola, Baptist Medical Centre, Nigeria
  • Abubakar Muhammad Musa, University of Maiduguri Teaching Hospital, Nigeria
  • Steve Goodacre, Northern General Hospital, UK
  • Suzanne Brady, Worthing Hospital, UK

new ethics approvals - Welcome to the trial:

  • Jorge Teves, Hospital Interzonal General de Agudos 'Dr Oscar Alende', Argentina
  • Luis Urbano, Hospital Privado Centro Medico De Cordoba, Argentina
  • Adalgiza Reyes Romero, Hospital Universitario Del Caribe, Colombia
  • Johnny Jerez, Hospital Naval Guayaquil, Ecuador
  • Dzneladze Zviad, Tbilisi State Medical University, Surgery Department, Georgia
  • Ignatius Ayo Falope, National Orthopaedic Hospital Igbobi, Nigeria
  • Anil P Lal, Aditya Neuroscience Centre, India
  • Ashok Pangi, KLE Hospital & Medical Research Centre, India
  • Rasananda Mangual, MKCG Medical College, India
  • Parag Sancheti, Sancheti Institute for Orthopaedics and Rehabilitation, India
  • Hemnant Magar, Sushrut Hospital, India
  • Susilo Chandra, Cipto Mangunkusumo Hospital, Indonesia
  • Gerardo Jose Illescas Fernandez, Nuevo Hospital Obregon, Mexico
  • Nene Obianyo, Enugu State University Teaching Hospital, Nigeria
  • Kalu Ugwu Okam, Federal Medical Centre Umuahia, Nigeria
  • Zumnan David Songden, University of Abuja Teaching Hospital, Nigeria
  • Alonso Soto Tarazona, Hospital Nacional Hipólito Unanue, Peru
  • Subash Gautam, Fujeirah Hospital, United Arab Emirates
  • Yacub Mulla, University Teaching Hospital Lusaka, Zambia
Background image: Hospital Universitario San Vicente de Paul, Colombia