Evaluation and Management of Hemoptysis in Infants and Children a Report of Nine Cases

Thompson, J. W.; Nguyen, Chi; Schoumacher, Robert; Lazar, Rande H.; Hamdan, Firas; Stocks, Rose Mary S.; Nguyen, Kinh Van

doi:10.1177/000348949610500704

Cited by 38 publications

(33 citation statements)

References 11 publications

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“…The presence of an infectious process (eg, necrotizing pneumonia, tuberculosis, lung abscess, infected bronchiectasis) leads to destruction of lung parenchyma and erosion of blood vessels, resulting in hemoptysis. Infections have been reported as the most common etiology of hemoptysis in several studies in children 4,5 and adults. [17][18][19]29 The results in the present study are very similar, with infections such as pneumonia, sepsis, tuberculosis, and tracheobronchitis representing 48% of the infections of all the patients in the Other group (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…1 Hemoptysis is a relatively uncommon but potentially serious problem in children. [2][3][4][5] It has become increasingly frequent in cystic fibrosis (CF) patients, 6,7 and is less commonly associated with tuberculosis, bronchiectasis, and other infections. 8 -10 The sudden presentation of hemoptysis requires the clinician to have adequate knowledge to make effective patient care decisions.…”

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confidence: 99%

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Hemoptysis: A 10-Year Retrospective Study

Coss‐Bu¹,

Sachdeva²,

Bricker³

et al. 1997

Pediatrics

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ABSTRACT. Background. Hemoptysis is uncommon in pediatric practice. We reviewed 10 years of experience with hemoptysis in a tertiary pediatric hospital to identify patient characteristics and predictors of mortality.Methods. Patients were divided into four age groups (0 to 5, 6 to 10, 11 to 20, and >20 years). Hemoptysis was defined as mild (<150 mL/day), large (150 to 400 mL/day), or massive (>400 mL/day). Fever was defined as 38.5°C.Results. A total of 228 patients (115 males and 113 females) with 246 episodes of hemoptysis were identified and grouped according to primary diagnosis. There were 149 patients in the cystic fibrosis (CF) group, 37 in the congenital heart disease (CHD) group, and 42 in the Other group. Age was significantly higher in the CF group compared with the CHD and Other groups. Length of stay was significantly prolonged in the CF group compared with the Other group. The overall mortality was 13%. After initial analysis, mortality predictors were age, amount of hemoptysis, receipt of blood products, and fever. After stratification, we found: 1) in the >20-year age group, there was a difference in mortality when comparing CF patients with CHD patients; 2) for patients who received blood products, there were differences in mortality in patients with CF, CHD, and Other diagnoses; 3) for patients who received blood, there were differences in mortality only for the 0-to 5-year age group; and 4) the amount of hemoptysis was predictive for mortality only in CHD patients.Conclusions. Hemoptysis presented in young adult CF patients and in adolescent CHD patients. Young adult CF patients with hemoptysis had a higher risk of mortality compared with young adult CHD patients.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Hemoptysis: A 10-Year Retrospective Study

Coss‐Bu¹,

Sachdeva²,

Bricker³

et al. 1997

Pediatrics

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“…4,5 However, among the pediatric population, blood-tinged sputum is most likely to be secondary to infection, foreign body aspiration, or tracheostomy related problems. 2,6,7 In 1990s, cystic fibrosis and congenital heart diseases (mitral stenosis) were reported as predominant etiologic factors for hemoptysis. 8 Currently, various etiologies are suggested including idiopathic pulmonary hemosiderosis, pulmonary vascular malformation, pulmonary arteriovenous fistula, bronchiectasis, pulmonary tuberculosis, and lung tumors, with cystic fibrosis accounting for only 5% of cases.…”

Section: Researchmentioning

confidence: 99%

Pediatric Pulmonary Hemorrhage vs. Extrapulmonary Bleeding in the Differential Diagnosis of Hemoptysis

Vaiman

Klin

Rosenfeld

et al. 2017

cajgh

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Introduction: Hemoptysis is an important symptom which causes a major concern, and warrants immediate diagnostic attention. The authors compared a group of patients with pediatric pulmonary hemorrhage with pediatric patients diagnosed with extrapulmonary bleeding focusing on differences in etiology, outcome and differential diagnosis of hemoptysis. Methods: We performed the retrospective analysis of medical charts of 134 pediatric patients admitted to the Emergency Department because of pulmonary and extrapulmonary hemorrhage and were diagnosed with suspected hemoptysis or developed hemoptysis (ICD10-CM code R04.2). The cases with pulmonary hemorrhage (Group 1) were compared with cases of extrapulmonary bleeding (Group 2) using the Fisher Exact test or Pearson's χ 2 test for categorical variables. The t-test was used to assess differences between continuous variables of the patients in the two groups. Results: Bloody cough was the presenting symptom in 73.9% of cases. 30 patients had pulmonary hemorrhage (Group 1), while 104 patients had extrapulmonary bleeding (Group 2). The underlying causes of bleeding in Group 2 included epistaxis, inflammatory diseases of nasopharynx and larynx, foreign bodies, gingivitis, and hypertrophy of adenoids. Mortality rate was 10% in Group 1, whereas Group 2 did not have any mortality outcomes during the observation period. Etiologycal factors were significantly different between hemoptysis and extrapulmonary bleeding in children Conclusions: Our research suggested that pulmonary and extrapulmonary bleeding are two conditions that differ significantly and cannot be unified under one diagnostic code. It is important to differentiate between focal and diffuse cases, and between pulmonary and extrapulmonary hemorrhage due to the diversity of clinical courses and outcomes.

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“…Coss-Bu ve arkadaşları pnömoniyi %31 olarak pulmoner kanama nedeni olarak bulmuşlar (10). Enfeksiyöz nedenler birçok çalışmada hemoptizi etyolojisinde en sık neden olarak bulunmuştur (11,12). Tüberkülozda yaygın olarak düşünülmesine rağmen literatürde çocukluk çağı ile ilgili birkaç vaka bildirilmiştir.…”

Section: Etyoloji̇unclassified

Hemoptysis in Childhood: Causes And Treatment

Pekcan¹

2015

Toraks Cer Bult

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Hemoptysis is the expectoration of hemorrhage originating from the tracheobronchial tree or lung parenchyma. Hemoptysis is a rare complaint in the pediatric population. It is most commonly of infectious etiology and is rarely life-threatening. Acute lower respiratory tract infections are the most common causes and include tracheobronchitis, pneumonia, and, less commonly, lung abscesses. Other causes include tracheostomy-related bleeding, bronchiectasis, tracheobronchial vascular anomalies, alveolar hemorrhage, respiratory tract foreign body or trauma, endobronchial tumors, aspiration of blood of gastrointestinal or upper aerodigestive tract origin, alveolar hemorrhage syndromes, and pulmonary thromboembolism. Hemoptysis in the pediatric patient presenting to the pediatrician warrants aggressive evaluation. The symptom is worrisome to the patient and parent, and the source can be both elusive and life-threatening. The patient history is often limited, and the physical exam is frequently non-specific. Treatment options focus on the etiology and include antibiotics for infectious causes and cystic fibrosis exacerbations, tracheostomy care modifications, steroids for and pulmonary hemosiderosis, and endoscopic removal of foreign body or endobronchial mass when indicated. Hemoptysis in the pediatric patient requires prompt and thorough evaluation and treatment. An efficient systematic evaluation is imperative in identifying the underlying etiology, and aggressive management is important because of the potential severity of the problem. Key words: Child, lung, hemorrhage, hemoptysis, diagnosis, treatment Özet Hemoptizi; trakeobronşiyal ağaç ya da akciğer parankiminden kaynaklanan kanamanın ekspektorasyonudur. Hemoptizi çocukluk çağında nadirdir. Genellikle enfeksiyoz nedenlidir ve nadiren yaşamı tehtid eder. Trakeobronşit, pnömoni ve daha az sıklıkla akciğer apselerini içeren akut alt solunum yolu enfeksiyonları en sık nedenleri içerir. Diğer nedenler trakeostomi ilişkili kanama, bronşektazi, trakeobronşiyal vasküler anomalileri, alveolar kanama, solunum yolu yabancı cisimleri veya travma, endobronşiyal tümörler, üst solunum yolu ve sindirim sistemi kökenli kanama, alveol ve pulmoner tromboemboliyi içerir. Hemoptizi ile gelen çocuk hastaların kliniği hekim tarafından agresif bir şekilde değer-lendirilmelidir. Şikayet ve belirti hasta ve ebeveyni endişelen-dirir, hemoptizi nedeni yaşamı tehdit edici olabilir. Hastanın öyküsü ve fizik muayene genellikle sınırlıdır ve sıklıkla özellik taşımaz. Tedavi seçeneklerinde etiyolojiye odaklanılır, enfeksiyöz nedenler ve kistik fibroz alevlenmelerinde antibiyotik tedavisi, pulmoner hemosiderosisde steroid, yabancı cisim ya da endobronşiyal kitle varlığında endoskopik çıkarılma yapılır. Çocuk hastada hemoptizi zamanında, kapsamlı bir değerlendirme ve tedavi gerektirir. Altta yatan problem ciddiyet taşıyabileceği için, problemi tanımlama ve agresif olarak yönetilmesi için uygun bir sistematik değerlendirme zorunludur.

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Evaluation and Management of Hemoptysis in Infants and Children a Report of Nine Cases

Cited by 38 publications

References 11 publications

Hemoptysis: A 10-Year Retrospective Study

Hemoptysis: A 10-Year Retrospective Study

Pediatric Pulmonary Hemorrhage vs. Extrapulmonary Bleeding in the Differential Diagnosis of Hemoptysis

Hemoptysis in Childhood: Causes And Treatment

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