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Ann Thorac Surg 2007;84:1373-1374
© 2007 The Society of Thoracic Surgeons

Case Reports

Successful Use of Recombinant Activated Coagulation Factor VII in a Patient with Massive Hemoptysis From a Penetrating Thoracic Injury

Homer C.N. Tien, MD, MSca,b,*, Michael R.C. Goughc,d, Robert Farrell, MD, MSce, John Macdonald, MD, MScb,f

a The Trauma Program and the Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
b Canadian Forces Health Services, Ottawa, Ontario, Canada
c St. George’s Hospital, University of London, London, United Kingdom
d Royal Army Medical Corps, British Army, London, United Kingdom
e Carbonear General Hospital, Newfoundland, Ottawa, Ontario, Canada
f Department of Critical Care Medicine, University of Ottawa, Ottawa, Ontario, Canada

Accepted for publication May 11, 2007.

* Address correspondence to Dr Tien, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Suite H186, Toronto, Ontario, M4N 3M5, Canada (Email: homer.tien{at}sunnybrook.ca).

Acute massive hemoptysis is a rare complication of pulmonary injury and contusion, and it is particularly difficult to manage in the nontertiary care setting. Recombinant activated coagulation factor VII (rFVIIa) is a prothrombotic drug that is increasingly being used to treat coagulopathy in massively exsanguinating trauma patients. We report a case in which recombinant activated coagulation factor VII successfully controlled massive hemoptysis and improved ventilation from a severe pulmonary contusion in a noncoagulopathic patient who suffered a penetrating thoracic injury in a military setting in Afghanistan.




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