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Recombinant factor VIIa as a rescue therapy in severe haemoptysis in a patient with a Fontan circulation
Thomas W Mason1, Andrew Retter1, Gareth J Morgan2
11Critical Care,St Thomas' Hospital, Guys and St Thomas' NHS foundation trust,London,United Kingdom.
Abstract:
We describe the successful use of recombinant factor VIIa (rFVIIa) in the control of massive haemoptysis in a 17-year-old patient with a Fontan circulation. The patient was intubated and ventilated in the ICU with deteriorating gas exchange. Conventional methods to control the haemoptysis were ineffective, and rFVIIa was successfully administered as a rescue therapy. rFVIIa is a powerful pro-thrombotic agent, which is only licensed in haemophiliacs with acquired inhibitors to anticoagulation. It has been used off-license in the treatment of massive haemorrhage, although a Cochrane review did not show any significant benefit; however, it may have a role as a rescue therapy where alternatives options have been exhausted after careful risk-benefit analysis.
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