Recombinant activated factor VII for life-threatening pulmonary hemorrhage after pediatric cardiac surgery

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Abstract
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.