Journal of the Formosan Medical Association
Volume 105, Issue 9 , Pages 765-769, 2006

Successful Treatment of Intractable Hemothorax with Recombinant Factor VIIa in a Nonhemophilic Patient

  • Yu-Feng Wei

      Affiliations

    • Department of Internal Medicine, National Taiwan University Hospital, Taipei
    • Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
    • ,
  • Chao-Chi Ho

      Affiliations

    • Department of Internal Medicine, National Taiwan University Hospital, Taipei
    • Department of Emergency Medicine, National Taiwan University Hospital, Taipei
    • Corresponding Author InformationCorrespondence to: Dr Chao-Chi Ho, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shang South Road, Taipei 100, Taiwan
    • ,
  • Ming-Tzer Lin

      Affiliations

    • Department of Internal Medicine, National Taiwan University Hospital, Taipei
    • ,
  • Ang Yuan

      Affiliations

    • Department of Emergency Medicine, National Taiwan University Hospital, Taipei
    • ,
  • Chong-Jen Yu

      Affiliations

    • Department of Internal Medicine, National Taiwan University Hospital, Taipei

Received 13 June 2005; received in revised form 15 September 2005; accepted 1 November 2005.

Article Outline

Recombinant factor VIIa (rFVIIa) was developed for the treatment of bleeding in hemophilic patients with inhibitors. It has also been used to stop bleeding in nonhemophilic patients who fail to respond to conventional treatment. We report a case of catastrophic hemothorax in which bleeding was stopped by administration of rFVIIa. A 68-year-old woman with chronic hepatitis C-related liver cirrhosis was admitted due to pneumonia and parapneumonic effusion. The patient developed hemothorax and hypovolemic shock after thoracentesis. Conventional therapies including tube thoracostomy and transarterial embolization failed to stop the life-threatening bleeding. The bleeding stopped after administration of rFVIIa 100 μg/kg/BW at 2-hour intervals for a total of two doses on the 3rd day of hospitalization. Despite intensive care, however, the patient died due to nosocomial infection and multiple organ failure on the 12th day of hospitalization. Hemothorax in a nonhemophilic patient can be successfully treated with rFVIIa.

Key Words:  hemothorax , nonhemophilia , recombinant factor VIIa

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PII: S0929-6646(09)60206-0

doi:10.1016/S0929-6646(09)60206-0

Journal of the Formosan Medical Association
Volume 105, Issue 9 , Pages 765-769, 2006

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