Clinical assessment and management of massive hemoptysis

Jean-Baptiste, Eddy

doi:10.1097/00003246-200005000-00066

Cited by 372 publications

(272 citation statements)

References 39 publications

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“…1,2,4) As an alternative, hemoptysis should be classified due to its severeness and life-threatening circumstance instead of its quantity. In our series of patients undergoing lung resection for life-threatening hemoptysis, 17 (54.8%) had a bleeding amount of 200-600 ml/day, and the rest 14 (45.2%) had an amount over 600 ml/day.…”

Section: Discussionmentioning

confidence: 99%

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Pulmonary Resection in the Treatment of Life-Threatening Hemoptysis

Kıral

Evman

Tezel

et al. 2015

ATCS

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Purpose: Massive hemoptysis is a life threatening situation with high mortality rates. Surgery is effective, however generally an avoided treatment. We report our experience with patients undergoing lung resection for life-threatening hemoptysis. Methods: Records of all surgically treated patients for hemoptysis between June 2009 and June 2012 were reviewed and analyzed retrospectively. Results: Anatomical resection was performed on 31 (15.3%) patients out of 203 patients referred to our intensive care unit for life-threatening hemoptysis. 25 (80.6%) were male and six (19.4%) were female; with mean age of 46.4 ± 13.7 (21-77). Pneumonectomy was performed in four (12.9%), lobectomy in 24 (77.4%), segmentectomy in two (6.5%) and bilobectomy in one case. Postoperative complications developed in eight (25.8%), and mortality was observed in two (6.5%) patients. Etiology was bronchiectasis in 13 (42.0%), tuberculosis in eight (25.8%), carcinoma in four (12.9%), aspergilloma in four (12.9%), hydatid cyst in one (3.2%) and lung abscess in one (3.2%) of the cases. Conclusions: Although lung resection in the treatment of massive hemoptysis is accompanied with high morbidity and mortality rates, surgery is the only permanent curative modality. Acceptable results can be achived in the company of a multidisciplinary approach, through avoidance of pneumonectomy and urgent surgery.

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Section: Discussionmentioning

confidence: 99%

“…Massive hemoptysis is associated with a mortality rate over 50%. 1,2) Several therapeutic strategies have been applied with variable results. Overall mortality, especially after emergent surgery, is still high, ranging from 10% to 38%.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Resection in the Treatment of Life-Threatening Hemoptysis

Kıral

Evman

Tezel

et al. 2015

ATCS

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“…83 Severe hemoptysis leading to uncontrolled bleeding and sudden death appears to be uncommon, with a mortality rate exceeding 50% if appropriate treatment is not immediately provided. [84][85][86][87][88] The source of massive hemoptysis 89 is predominantly the bronchial circulation (90%), rather than the pulmonary circulation (5%), and in a minority of cases it may originate from the aorta or the systemic arterial supply to the lungs.…”

Section: Hemoptysismentioning

confidence: 99%

Complications Leading to Sudden Cardiac Death in Pulmonary Arterial Hypertension

Demerouti

Manginas²,

Athanassopoulos

et al. 2012

Respir Care

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SummaryPulmonary arterial hypertension (PAH) is a disease of small pulmonary arteries, characterized by vascular proliferation and remodeling. Progressive increase in pulmonary vascular resistance ultimately leads to right ventricular heart failure and death. PAH-specific drug therapy has improved clinical outcomes and survival. While the survival is better, progression of pulmonary vasculopathy contributes to pulmonary artery dilatation. Left main compression syndrome, pulmonary artery dissection, pulmonary artery rupture, and severe hemoptysis are reported as complications leading to sudden cardiac death, an event encountered more often in PAH patients. The advent of PAHtargeted drug therapy has reduced referral for lung transplantation; however, severe complications require rapid diagnosis, decision making, and possible registration on a lung transplantation waiting list. PAH referral centers provide multidisciplinary emergency care and specific therapeutic management, contributing to improved quality of life and survival for PAH patients. We review the complications leading to sudden death in PAH. Key words: pulmonary hypertension; pulmonary artery dissection; pulmonary artery rupture; left main compression syndrome. [Respir Care 2013;58(7):1246 -1254.

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“…Pulmoner vasküler yapıların duvarı musküler tabaka ile donatılmış olup, farmakolojik metodlar (vasopressin veya aeresol adrenalin gibi) veya fiziksel metodlar (bronşiyal soğuk lavaj uygulanımı) kullanılarak kanama yavaşlatılabilir ya da durdurulabilir. Bu hipertrofik neovaskülarizasyonu ortadan kaldırmak için perkütan embolizasyon da güvenilir bir yöntem olarak görül-mektedir [3,6,19]. Bronşiyal arter embolizasyonunun (BAE) hemoptizi kontrolünde etkinliği geniş serili makaleler incelenerek değerlendirilmiştir.…”

Section: Gereç Ve Yöntemunclassified

“…Ancak operasyon sırasında masif bir kanama olursa acil pnömonektomi dahi gerekebilir. Opere edilen vakalarda rekürrens oranı çok daha azdır [3,19]. Masif hemoptizi olgularında ise cerrahi tedavi seçeneği en iyi uzun süreli sonuçları vermesine karşın kontrendike olduğu durumlar ve yüksek morbidite ve mortalite oranları nedeni ile tartışmalıdır [23].…”

Section: Gereç Ve Yöntemunclassified

Surgical Treatment of Hemoptysis: Analysis of 17 Cases

Çobanoğlu¹,

Sayır²,

Sertoğullarından³

2012

Ann Clin Anal Med

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ÖzetAmaç: Bu çalışmada, ameliyat edilmiş hemoptizili olgular retrospektif olarak analiz edildi. Literatür eşliğinde tartışıldı. Gereç ve Yöntem: 2004 ile 2010 tarihleri arasında hastanemize başvuran ve ameliyat edilen 17 hemoptizili hasta retrospektif olarak değerlendirildi. Hastaların yaşı, cinsiyeti, altta yatan pul¬moner hastalık, semptomlar, teşhisi, tedavi biçimi, cerrahi endikasyonlar, nüks, morbidite ve mortalite oranları açısından gözden geçirildi. Bulgular: Olguların 6'sı kadın, 11'i erkek ve ortalama yaşları 37.47±13.25 yıl olarak bulundu. En sık hemoptizi nedenleri akciğer kanseri (% 29.41), aktif akciğer tüberkülozu, bronşiektazi ve kist hidatik idi (%17.64). Oniki (%70.59) olguda ilk hemoptizi atağı, 5 (%29.41) olguda ise rekürren hemoptizi mevcuttu. Onyedi olgunun 6'sında (%32.30) hafif hemoptizi vardı ve bunların 3'ünde (%50) neden akciğer kanseriydi. En sık görülen ek semptom öksürük ve halsizlikti (%44.17). Göğüs radyogramında 8 (%47.05) olguda lezyon izlenirken, toraks BT'de 13 (%76.47), bronkoskopide 7 (%58.33) olguda patoloji izlendi. Olguların tedavisinde posteriolateral torakotomi ( 12 olgu) ve video yardımlı torakosko¬pik cerrahi (5 olgu) uygulandı. Morbidite 3 olguda (%17.64) mevcuttu. Mor¬talite oranı %5.88 idi (n:1). Bu seride bir (%5.88) olguda nüks gelişti. Sonuç: Sonuç olarak, hemoptizinin en sık nedeni olarak akciğer kanseri saptandı. Tanısal değerlendirmede toraks BT'nin bronkoskopiye göre daha yüksek bir değere sahip olduğu görüldü. Özellikle lokalize lezyonlardan kaynaklanan hemoptizide cerrahi seçenek ön plana çıkmaktadır. Masif kanamalar acil cerrahi müdahaleyi gerekli kılabilir. Anahtar KelimelerHemoptizi; Etiyoloji; Cerrahi Tedavi Abstract Aim: In this study, the patients who underwent surgery for hemoptysis were analyzed retrospectively. The cases were discussed with the literature. Material and Method: Seventeen patients who were admitted to our hospital and underwent surgery for hemoptysis between 2004 and 2010, were retrospectively reviewed. Age, gender, underlying pulmonary disease, symptoms, diagnosis, treatment type, surgical indication, morbidity, recurrence, mortality of the patients were reviewed. Results: Mean age of the 17 patients (6 women, 11 men) was 37.47±13.25. The most common causes of hemoptysis were lung cancer (29.41%), active pulmonary tuberculosis, bronchiectasis and hydatid cyst (17.64%). It was the first hemoptysis attack in 12(70.59%) cases and was recurrent in 5(29.41%) cases. 6 of 17 cases (32.30%) had mild hemoptysis and in 3 of those (50%) the reason of hemoptysis was lung cancer. The most common associating symptoms were cough and weakness (44.17%). There were abnormal findings on chest radiograph of the 8 (47.05%) of the cases, while in thorax CT images of 13 (76.47%) and 7 (58.33%) of bronchoscopy. We treated these patients with posterolateral thoracotomy (12 cases) and Video-Assisted Thoracoscopic Surgery (5 cases). The morbidity was seen in 3 patients (17.64%). The mortality rate was 5.88% (n:1). Recurrence developed in 1 (5.88%) patients in...

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Clinical assessment and management of massive hemoptysis

Cited by 372 publications

References 39 publications

Pulmonary Resection in the Treatment of Life-Threatening Hemoptysis

Pulmonary Resection in the Treatment of Life-Threatening Hemoptysis

Complications Leading to Sudden Cardiac Death in Pulmonary Arterial Hypertension

Surgical Treatment of Hemoptysis: Analysis of 17 Cases

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