Leibovitch Leah, Kenet Gili, Mazor Kineret, Matok Ilan, Vardi Amir, Barzilay Zohar, Paret Gideon
Department of Pediatric Intensive Care and Pediatric Cardiac Surgery, Tel Aviv University, Tel Aviv, Israel.
Pediatr Crit Care Med. 2003 Oct;4(4):444-6. doi: 10.1097/01.PCC.0000074276.20537.0A.
To report intractable life-threatening pulmonary hemorrhage after cardiac surgery in an infant who was treated successfully with recombinant activated factor VII (rFVIIa).
Descriptive case report.
An 18-bed pediatric intensive care unit at a tertiary-care children's hospital.
A 10-wk-old child with acute life-threatening pulmonary hemorrhage after cardiac surgery.
General supportive intensive care.
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.
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.
