Acute Emergency Management of Pulmonary Hemorrhage in Children

Abstract

A cute care physicians face challenging diagnosis and management issues of children presenting with acute pulmonary hemorrhage from time to time. 1 We have managed children with alarming pulmonary hemorrhage and massive hemoptysis in children with hemosiderosis, pulmonary hypertension, autoimmune and hemolytic disease. These events have prompted us to examine existing literature for updated information and approach to acute management and counseling of the parents (Fig) . A flowchart is proposed to facilitate management of this life-threatening condition. ETIOLOGIESAcute pulmonary hemorrhage is uncommon and alarming to the patients and their caregivers. Pulmonary hemorrhage can be defined as bleeding from the tracheobronchial tree or alveolar environment. A volume-related definition of hemoptysis has been proposed, with scant (<5 mL), mild to moderate hemoptysis (5-240 mL), and massive when more than 240 mL in a 24-hour period. 2 FIGURE 1. Acute pulmonary hemorrhage flowchart.