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.