Treatment of severe pulmonary hemorrhage with activated recombinant factor VII (rFVIIa) in very low birth weight infants.

Clinically apparent pulmonary hemorrhage (PH) occurs in 5% to 7% of very low birth weight (VLBW) infants with respiratory distress syndrome (RDS). It is associated with a mortality rate as high as 50% and significant pulmonary and central nervous system morbidities. There is no consensus on treatment modality. We present two VLBW infants with severe PH that did not respond to conventional treatment but were successfully treated with activated recombinant factor VII (rFVIIa). No untoward side effects were noted.