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Figure 1 | Critical Care

Figure 1

From: Successful pulmonary administration of activated recombinant factor VII in diffuse alveolar hemorrhage

Figure 1

Rationale for the local mode of action of intra-alveolar human recombinant activated factor VII (rFVIIa) in diffuse alveolar hemorrhage (DAH). Intravenous rFVIIa does not reach the alveoli in a sufficient concentration (1) in contrast to the airway route (2). Alveolar tissue factor (TF)-FVIIa complex activates coagulation factor IX and X. TF and TF pathway inhibitor (TFPI) are constitutively expressed in the airspace, secondary to inflammation induced in DAH (3). TFPI counteracts the activation effect of the FVIIa-TF complex. Alveolar rFVIIa in high concentration counteracts the TFPI anticoagulation (4).

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