Wednesday June 20, 2007
Resistant (uncontrolled bleeding) / Life-threatening diffuse alveolar

hemorrhageDiffuse alveolar hemorrhage remained a condition with high mortality. Usual treatment is high dose IV metilprednisolone (1g/day) for three to five days and in more severe cases to add IV cyclophosphamide (cyclophosphamide has a delayed effect, but may provide synergistic action with steroid). Plasmapheresis has been described to be effective particularly in diffuse alveolar hemorrhage associated with Goodpasture syndrome.But what if bleeding is non-stop and life-threatening ?Answer is off label use of activated Factor VII. In 3 cases reported from University of North Carolina at Chapel Hill - bleeding stops and oxygenation improved within minutes 1.


Reference: click to get abstract

Successful Treatment of Diffuse Alveolar Hemorrhage with Activated Factor VII - 16 March 2004 Volume 140 Issue 6 Pages 493-494