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.
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.