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Local pulmonary administration of factor VIIa (rFVIIa) in massive pulmonary haemorrhage in post-operative cardiac infant

Published online by Cambridge University Press:  26 September 2022

Hussam K Hamadah Open the ORCID record for Hussam K Hamadah [Opens in a new window]  and
Mohamed S. Kabbani
Hussam K Hamadah*
Affiliation:
King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
Mohamed S. Kabbani
Affiliation:
King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia King Abdullah International Medical Research Center, Riyadh, Saudi Arabia King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
*
Author for correspondence: H. K. Hamadah, Section of Pediatric Cardiac ICU, King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Mail Code: 1423, P.O Box 22490, Riyadh 11426, Saudi Arabia. Tel: 966118011111, ext 13621; Fax: 966118011111, ext 16773. E-mail: Hamadahmo@ngha.med.sa
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Abstract

Diffuse pulmonary haemorrhage is an ominous condition that has a high paediatric mortality rate. Recombinant activated factor VIIa (rFVIIa) is a powerful haemostatic agent which has been used intravenously in life-threatening haemorrhage in variety of conditions in which conventional medical or surgical therapy are unsuccessful. We report off-label successful use of endotracheal rFVIIa for massive life-threatening respiratory haemorrhage following aspiration and cardiopulmonary resuscitation in a 3-month-old infant who was anticoagulated with enoxaparin following corrective cardiac surgery with other comorbidities. Off-label administration of endotracheal rFVIIa permitted rapid safe control of massive pulmonary haemorrhage and prevented further detrimental decline in respiratory function with satisfactory outcome.

Keywords

Pulmonary haemorrhagerecombinant factor rFVIIacardiac surgery
Type
Brief Report
Information
Cardiology in the Young , Volume 33 , Issue 5 , May 2023 , pp. 835 - 837
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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