Recombinant activated factor VII for life-threatening pulmonary hemorrhage after pediatric cardiac surgery.
OBJECTIVE
To report intractable life-threatening pulmonary hemorrhage after cardiac surgery in an infant who was treated successfully with recombinant activated factor VII (rFVIIa).


METHODS
Descriptive case report.


METHODS
An 18-bed pediatric intensive care unit at a tertiary-care children's hospital.


METHODS
A 10-wk-old child with acute life-threatening pulmonary hemorrhage after cardiac surgery.


METHODS
General supportive intensive care.


RESULTS
Care included mechanical ventilatory support, inotropic support, and concurrent treatment with blood products (packed cells, platelet concentrates, and plasma-derived products), as well as aprotinin and desmopressin to improve hemostasis. The addition of rFVIIa resulted in complete resolution of the hemorrhage.


CONCLUSIONS
rFVIIa should be considered as a possible novel therapeutic approach to be used as rescue therapy for patients presenting with massive life-threatening hemorrhage progressing into hemorrhagic shock. Further controlled trials to elucidate the safety of this treatment are warranted.
Leibovitch
Leah
L
Department of Pediatric Intensive Care and Pediatric Cardiac Surgery, Tel Aviv University, Tel Aviv, Israel.
Kenet
Gili
G
Mazor
Kineret
K
Matok
Ilan
I
Vardi
Amir
A
Barzilay
Zohar
Z
Paret
Gideon
G
D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D004314:Down Syndrome / Q000601:surgery; D005167:Factor VII / Q000627:therapeutic use*; D015942:Factor VIIa; D005260:Female; D006801:Humans; D007223:Infant; D008171:Lung Diseases / Q000188:drug therapy* / Q000209:etiology*; D019106:Postoperative Hemorrhage / Q000188:drug therapy* / Q000209:etiology*; D011994:Recombinant Proteins / Q000627:therapeutic use*
D011994:Recombinant Proteins; D005167:Factor VII; C103587:recombinant FVIIa; D015942:Factor VIIa