Edward et al carried out a survey in the American College of Chest Physicians (ACCP) in 1998 on the treatment of acute haemoptysis: 85% of specialists answered that intubation and connection to mechanical ventilation must be performed at an early stage and 64% considered it mandatory to carry out a fibrobronchoscopy during the first 24 hours [6] . Consequently, treatment undertaken in both clinical cases presented -mechanical ventilation support and fibrobronchoscopy -meets these recommendations and was performed as an emergency measure to treat a massive haemoptysis episode. In middle-sized hospital, where selective embolization of the bronchial artery techniques and/or thoracic surgery are not available, systemic rFVIIa has been used in massive haemoptysis cases, with good results [7] . DAH in haematological patients requiring mechanical ventilation has a high mortality rate of over 70% in series described [8, 9] . This is due to the absence of specific treatment for DAH of haematological origin. The results of a multicentre, randomised study on the efficacy and safety of three different dosages of systemic rFVIIa compared with a placebo in treating haemorrhagic complications in 100 bone-marrow transplant patients (seven with DAH) were inconclusive, 8% of thromboembolic events were observed in the group treated with rFVIIa [10] .