title: Life-threatening hemorrhage in neonates: management with recombinant activated factor VII.
abstract: OBJECTIVE
  Massive hemorrhage with shock is a common problem for the intensivist. The use of recombinant activated factor VII (rFVIIa), known as efficient treatment for hemophilia, has been reported to control severe bleeding episodes in critically care patients, but never in preterm neonates.
  
  
  METHODS
  Case report (two cases) and review of the literature.
  
  
  METHODS
  Neonatal intensive care unit, university teaching hospital.
  
  
  METHODS
  Two preterm neonates with life-threatening hemorrhages, from the liver and spleen in one patient and from the lung in the other.
  
  
  METHODS
  Intravenous administration of 150/200 microg/kg of rFVIIa (Novoseven, NovoNordisk, Copenhagen, Denmark).
  
  
  RESULTS
  Complete hemostasis 10 min after the second bolus in the two patients.
  
  
  CONCLUSIONS
  For the intensivist, the successful use of rFVIIa in these patients and others lacking pre-existing coagulopathies points to rFVIIa as a novel therapeutic approach for patients presenting with massive life-threatening hemorrhage.
authors.affiliation: Department of Pediatrics, Division of Neonatalogy, J W Goethe University Hospital, Theodor Stern Kai 7, 60590 Frankfurt/Main, Germany. alex.veldman@kgu.de
authors.forename: Alex
authors.initials: A
authors.lastname: Veldman
authors.forename: Doris
authors.initials: D
authors.lastname: Fischer
authors.forename: Burkhard
authors.initials: B
authors.lastname: Voigt
authors.forename: Peter A
authors.initials: PA
authors.lastname: Beyer
authors.forename: Rolf
authors.initials: R
authors.lastname: Schlösser
authors.forename: Antje
authors.initials: A
authors.lastname: Allendorf
authors.forename: Wolfhardt
authors.initials: W
authors.lastname: Kreuz
mesh_terms: D005167:Factor VII / Q000627:therapeutic use*; D017809:Fatal Outcome; D006470:Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D011994:Recombinant Proteins / Q000627:therapeutic use*
chemical_list: D011994:Recombinant Proteins; D005167:Factor VII