Massive pulmonary hemorrhage can be a life-threatening condition that may be difficult to control. Infusion of recombinant factor VIIa can be used to control the bleeding.


Causes of massive pulmonary hemorrhage:

(1) pneumonia

(2) following allogeneic hematopoietic stem cell transplant

(3) metastastic choriocarcinoma to the lung

(4) autoimmune vasculitis


The hemorrhage may be exacerbated by thrombocytopenia, deficiency in coagulation factors, anticoagulants and anti-platelet medications. For recombinant factor VIIa to be effective the patient must have an adequate level of coagulation factors and platelets.


Dose of recombinant factor VIIa sued by Wheater et al: 100 micrograms per kg body weight


Tests used to monitor the patient:

(1) arterial blood gases

(2) chest X-ray

(3) need for supplemental oxygen


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