Introduction
Large volume fluid replacement to treat haemorrhagic shock can result in haemostatic failure due both to a dilution effect [1] and an intrinsic effect [2,3]. Recombinant factor Vlla (rVlla) is seen increasingly as a possible universal haemostatic agent that could act to reverse or even prevent the dilution and intrinsic effects of fluids used within the 'golden' hour of haemorrhagic shock. Our preliminary findings demonstrated that rVlla appeared to improve markers of global haemostasis in a model of large volume fluid replacement. This follow up study assessed what effects rVlla had on global haemostasis and the electron microscopic appearances of clot formation when haemaccel or sodium chloride were used as diluents to create a model of large volume fluid replacement.