Intrapulmonary Recombinant Factor VII as an Effective Treatment for Diffuse Alveolar Hemorrhage
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-...
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2016
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| Online Access: | http://hdl.handle.net/10725/10031 http://dx.doi.org/10.1097/LBR.0000000000000286 http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php https://oce.ovid.com/article/01436970-201607000-00016/HTML |
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| _version_ | 1864513485772161024 |
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| author | Diab, Khalil J. |
| author2 | Baker, Mary S. Carlos, W. Graham Mathur, Praveen |
| author2_role | author author author |
| author_facet | Diab, Khalil J. Baker, Mary S. Carlos, W. Graham Mathur, Praveen |
| author_role | author |
| dc.creator.none.fl_str_mv | Diab, Khalil J. Baker, Mary S. Carlos, W. Graham Mathur, Praveen |
| dc.date.none.fl_str_mv | 2016 2019-02-13T11:10:42Z 2019-02-13T11:10:42Z 2019-02-13 |
| dc.identifier.none.fl_str_mv | 1944-6586 http://hdl.handle.net/10725/10031 http://dx.doi.org/10.1097/LBR.0000000000000286 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. http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php https://oce.ovid.com/article/01436970-201607000-00016/HTML |
| dc.language.none.fl_str_mv | en |
| dc.relation.none.fl_str_mv | Journal of Bronchology & Interventional Pulmonology |
| dc.rights.*.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.title.none.fl_str_mv | Intrapulmonary Recombinant Factor VII as an Effective Treatment for Diffuse Alveolar Hemorrhage A Case Series |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | 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. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | LAURepo_c5ba6d5f5a694fe4df9b5d15a5e438c6 |
| identifier_str_mv | 1944-6586 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. |
| language_invalid_str_mv | en |
| network_acronym_str | LAURepo |
| network_name_str | Lebanese American University repository |
| oai_identifier_str | oai:laur.lau.edu.lb:10725/10031 |
| publishDate | 2016 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| spelling | Intrapulmonary Recombinant Factor VII as an Effective Treatment for Diffuse Alveolar HemorrhageA Case SeriesDiab, Khalil J.Baker, Mary S.Carlos, W. GrahamMathur, PraveenBackground: 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.PublishedN/A2019-02-13T11:10:42Z2019-02-13T11:10:42Z20162019-02-13Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article1944-6586http://hdl.handle.net/10725/10031http://dx.doi.org/10.1097/LBR.0000000000000286Baker, 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.http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.phphttps://oce.ovid.com/article/01436970-201607000-00016/HTMLenJournal of Bronchology & Interventional Pulmonologyinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/100312021-03-19T10:45:31Z |
| spellingShingle | Intrapulmonary Recombinant Factor VII as an Effective Treatment for Diffuse Alveolar Hemorrhage Diab, Khalil J. |
| status_str | publishedVersion |
| title | Intrapulmonary Recombinant Factor VII as an Effective Treatment for Diffuse Alveolar Hemorrhage |
| title_full | Intrapulmonary Recombinant Factor VII as an Effective Treatment for Diffuse Alveolar Hemorrhage |
| title_fullStr | Intrapulmonary Recombinant Factor VII as an Effective Treatment for Diffuse Alveolar Hemorrhage |
| title_full_unstemmed | Intrapulmonary Recombinant Factor VII as an Effective Treatment for Diffuse Alveolar Hemorrhage |
| title_short | Intrapulmonary Recombinant Factor VII as an Effective Treatment for Diffuse Alveolar Hemorrhage |
| title_sort | Intrapulmonary Recombinant Factor VII as an Effective Treatment for Diffuse Alveolar Hemorrhage |
| url | http://hdl.handle.net/10725/10031 http://dx.doi.org/10.1097/LBR.0000000000000286 http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php https://oce.ovid.com/article/01436970-201607000-00016/HTML |