TY - JOUR
T1 - Bronchoscopic Intrapulmonary Recombinant Factor VIIa for Diffuse Alveolar Hemorrhage-induced Acute Respiratory Failure in MPO-ANCA Vasculitis
T2 - A Case Report
AU - Smesseim, Illaa
AU - Schaepman-Ruys, Titia
AU - Duitman, Jan Willem
AU - Vegting, Yosta
AU - Raasveld, Jorinde
AU - Hilhorst, Marc
AU - Vlaar, Alexander
AU - van Es, Josien
AU - Bonta, Peter
N1 - © 2022 Illaa Smesseim, Titia Schaepman-Ruys, Jan Willem Duitman, Yosta Vegting, Jorinde Raasveld, Marc Hilhorst, Alexander Vlaar, Josien van Es, Peter Bonta, published by Sciendo.
PY - 2022/4/1
Y1 - 2022/4/1
N2 - Introduction: Diffuse alveolar haemorrhage (DAH) is a potentially life-Threatening disease, characterized by diffuse accumulation of red blood cells within the alveoli. It can be caused by a variety of disorders. In case DAH results in severe respiratory failure, veno-venous extracorporeal membrane oxygenation (VV-ECMO) can be required. Since VV-ECMO coincides with the need for anticoagulation therapy, this results in a major clinical challenge in DAH patients with hemoptysis. Case presentation: We report a patient case with severe DAH-induced acute respiratory failure and hemoptysis in need for VV-ECMO complicated by life-Threatening membrane oxygenator thrombosis. The DAH-induced hemoptysis was successfully treated with local bronchoscopic recombinant factor VIIa (rFVIIa), allowing systemic anticoagulation to prevent further membrane oxygenator thrombosis. Neither systemic clinical side effects nor differences in the serum coagulation markers occurred after applying recombinant factor VIIa (rFVIIa) treatment endobronchially. Conclusion: This is, to our knowledge, the first case that reports the use of rFVIIa in a patient with DAH due to vasculitis and in need for VV-ECMO complicated by membrane oxygenator thrombosis.
AB - Introduction: Diffuse alveolar haemorrhage (DAH) is a potentially life-Threatening disease, characterized by diffuse accumulation of red blood cells within the alveoli. It can be caused by a variety of disorders. In case DAH results in severe respiratory failure, veno-venous extracorporeal membrane oxygenation (VV-ECMO) can be required. Since VV-ECMO coincides with the need for anticoagulation therapy, this results in a major clinical challenge in DAH patients with hemoptysis. Case presentation: We report a patient case with severe DAH-induced acute respiratory failure and hemoptysis in need for VV-ECMO complicated by life-Threatening membrane oxygenator thrombosis. The DAH-induced hemoptysis was successfully treated with local bronchoscopic recombinant factor VIIa (rFVIIa), allowing systemic anticoagulation to prevent further membrane oxygenator thrombosis. Neither systemic clinical side effects nor differences in the serum coagulation markers occurred after applying recombinant factor VIIa (rFVIIa) treatment endobronchially. Conclusion: This is, to our knowledge, the first case that reports the use of rFVIIa in a patient with DAH due to vasculitis and in need for VV-ECMO complicated by membrane oxygenator thrombosis.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85169771669&origin=inward
U2 - https://doi.org/10.2478/jccm-2022-0004
DO - https://doi.org/10.2478/jccm-2022-0004
M3 - Article
C2 - 35950153
SN - 2393-1809
VL - 8
SP - 123
EP - 125
JO - Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures)
JF - Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures)
IS - 2
ER -