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Recombinant activated factor VII for life-threatening pulmonary hemorrhage after pediatric cardiac surgery
Leah Leibovitch1, Gili Kenet, Kineret Mazor
1Department of Pediatric Intensive Care and Pediatric Cardiac Surgery, Tel Aviv University, Tel Aviv, Israel.
Objective:
To report intractable life-threatening pulmonary hemorrhage after cardiac surgery in an infant who was treated successfully with recombinant activated factor VII (rFVIIa).
Design:
Descriptive case report.
Setting:
An 18-bed pediatric intensive care unit at a tertiary-care children's hospital.
Patient:
A 10-wk-old child with acute life-threatening pulmonary hemorrhage after cardiac surgery.
Interventions:
General supportive intensive care.
Measurements And Main 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.
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