Clin Pediatr Hematol Oncol.  2016 Apr;23(1):42-45. 10.15264/cpho.2016.23.1.42.

Use of Recombinant Activated Factor VII for Pulmonary Hemorrhage in Premature Infants: A Single-Center Experience

• Park HJ
• Choi EJ

• KMID: 2168907
• DOI: http://doi.org/10.15264/cpho.2016.23.1.42

Abstract

BACKGROUND
Pulmonary hemorrhage in prematurity is a life-threatening complication and associated with a high mortality. Recombinant activated factor VII (rFVIIa) has been reported as hemostatic treatment in sick neonates with refractory bleeding events in many studies. We evaluated the efficacy and safety of rFVIIa in prematurity with pulmonary hemorrhage in our institution.
METHODS
From the prematurities who were treated with rFVIIa to pulmonary hemorrhage from January 2010 to December 2015, we retrospectively analyzed the results of rFVIIa.
RESULTS
Of the 29 prematurities who were treated with rFVIIa for pulmonary hemorrhage, fifteen were male and fourteen were female. The median gestational age was 27 1/7 weeks (range, 22 1/7-34 1/7 weeks) and median birth weight was 870 g (range, 470-2,070 g). One to eight doses of rFVIIa (median dose 115.6 µg/kg/dose) were administered, with 16 (55%) patients receiving a single dose. Hemostatic effect was achieved in 21 (72.4%) cases, but 6 of 21 patients died of unrelated cause, and overall mortality was 14 of 29 (48.3%). Thrombotic adverse event was not observed in any of our patients.
CONCLUSION
Although the number of patients included in this study was small and the fact that this was a retrospective non-randomized control study, rFVIIa could be considered as a therapeutic option for pulmonary hemorrhage in prematurity.

Keyword

Pulmonary hemorrhage; Prematurity; Recombinant; Activated factor VII

MeSH Terms

Birth Weight
Factor VIIa*
Female
Gestational Age
Hemorrhage*
Humans
Infant, Newborn
Infant, Premature*
Male
Mortality
Retrospective Studies
Factor VIIa