Intrapulmonary Recombinant Factor VII as an Effective Treatment for Diffuse Alveolar Hemorrhage

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dc.contributor.author Diab, Khalil J.
dc.contributor.author Baker, Mary S.
dc.contributor.author Carlos, W. Graham
dc.contributor.author Mathur, Praveen
dc.date.accessioned 2019-02-13T11:10:42Z
dc.date.available 2019-02-13T11:10:42Z
dc.date.copyright 2016 en_US
dc.date.issued 2019-02-13
dc.identifier.issn 1944-6586 en_US
dc.identifier.uri http://hdl.handle.net/10725/10031
dc.description.abstract Background: The diffuse alveolar hemorrhage (DAH) syndrome is a life-threatening pulmonary complication related to systemic vasculitides, posthematopoietic stem cell transplantation, drugs, or toxins. Once DAH develops, the mortality rate is as high as 50% to 80%. Initial treatment consists of high-dose steroids and supportive measures, including mechanical ventilation. We present a case series of 6 patients treated with intrapulmonary recombinant factor VIIa (rFVIIa) to treat refractory DAH. Methods: Six patients with DAH were treated with intrapulmonary instillation of rFVIIa. Doses were divided equally between the right and the left lungs. Doses were 30, 50, or 60 mcg/kg and frequencies varied from a single administration to repeated doses on subsequent days on the basis of the clinical response. All patients received high-dose steroids, and 4 also received an aminocaproic acid infusion. Results: Intrapulmonary rVFIIa treated DAH effectively in 5 of 6 patients. Doses used were smaller and less frequent than those described previously. Conclusions: Intrapulmonary factor VII is an effective adjunctive treatment for DAH. We achieved treatment success with both smaller and less frequent doses than those described previously. This may be a good therapeutic option for DAH, particularly when standard therapies have failed or bleeding is immediately life threatening. It is possible that intrapulmonary rFVIIa could save costs, while improving the intensive care unit length of stay. Further prospective studies are needed to assess the optimal dose and frequency for adequate therapeutic efficacy. en_US
dc.language.iso en en_US
dc.title Intrapulmonary Recombinant Factor VII as an Effective Treatment for Diffuse Alveolar Hemorrhage en_US
dc.type Article en_US
dc.description.version Published en_US
dc.title.subtitle A Case Series en_US
dc.author.school SOM en_US
dc.author.idnumber 201900605 en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Journal of Bronchology & Interventional Pulmonology en_US
dc.journal.volume 23 en_US
dc.journal.issue 3 en_US
dc.article.pages 255-258 en_US
dc.identifier.doi http://dx.doi.org/10.1097/LBR.0000000000000286 en_US
dc.identifier.ctation Baker, M. S., Diab, K. J., Carlos, W. G., & Mathur, P. (2016). Intrapulmonary recombinant factor VII as an effective treatment for diffuse alveolar hemorrhage: a case series. Journal of bronchology & interventional pulmonology, 23(3), 255-258. en_US
dc.author.email khalil.diab@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url https://oce.ovid.com/article/01436970-201607000-00016/HTML en_US
dc.orcid.id https://orcid.org/0000-0001-9255-7575 en_US
dc.author.affiliation Lebanese American University en_US

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