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Desmopressin Therapy for Massive Hemoptysis Associated with Severe Leptospirosis

Critical Care and Clinical Biology Units, Centre Hospitalier Territorial, Papeete, Tahiti

Correspondence and requests for reprints should be addressed to Laurent Roda, Clinical Biology Unit, Centre Hospitalier Territorial, BP1640, Papeete, Tahiti, Polynésie Française. E-mail: rodal{at}mail.pf

Massive hemoptysis in patients with severe leptospirosis is often resistant to conventional therapies and can rapidly become fatal. Desmopressin is a fast-acting blood-saving agent used in various hereditary and acquired clotting disorders. We used desmopressin infusions to treat massive pulmonary hemorrhage in six leptospirosis patients with respiratory failure, shock, and multiple organ dysfunction. Hemoptysis ceased rapidly in every case, and five patients finally recovered. Two additional patients with less severe hemoptysis were also successfully treated.

Key Words: Weil's disease • respiratory distress syndrome • hemorrhage • hemostatics • receptors, vasopressin

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