Hemoptysis after Batroxobin Infusion Using a Fiberoptic Bronchoscope

Bhambure, N. M; Abhyankar, Nitin; Gandhi, Y. P; Shah, Ajendra C.; Patel, Yatin; Deshmukh, Shamrao N.

doi:10.1378/chest.99.5.1313a

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“…Batroxobin reduces the bleeding time and the need for blood transfusion in patients with trauma or those undergoing surgery (2,(9)(10)(11)(12). Bronchoscopy with the bronchial infusion of batroxobin was also effective in treating patients with massive hemoptysis (15)(16)(17). Additionally, batroxobin can be administered systemically to patients with hemoptysis to control bleeding (2,6,20,28).…”

Section: Discussionmentioning

confidence: 99%

“…Batroxobin forms a fibrin clot by degrading fibrinogen into fibrin, which exerts a hemostatic effect (13,14). Batroxobin can be topically administered using bronchoscopy with an infusion or systemically to patients with hemoptysis (6,(15)(16)(17). However, there have been reports of bleeding associated with acquired hypofibrinogenemia following batroxobin administration (12,(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

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Risk factors and clinical outcomes associated with acquired hypofibrinogenemia in patients administered hemocoagulase batroxobin for hemoptysis

Lee¹,

Yoon²,

Na³

et al. 2023

J Thorac Dis

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Background: Hemocoagulase batroxobin is used to prevent hemostasis or bleeding in surgical and trauma patients; however, the role of batroxobin in patients with hemoptysis is not well understood. We evaluated the risk factors and prognosis of acquired hypofibrinogenemia in hemoptysis patients treated systemically with batroxobin.Methods: We retrospectively reviewed the medical charts of hospitalized patients who were administered batroxobin for hemoptysis. Acquired hypofibrinogenemia was defined as a plasma fibrinogen level >150 mg/dL at baseline, decreasing to <150 mg/dL after batroxobin administration.Results: Overall, 183 patients were enrolled, of whom 75 had acquired hypofibrinogenemia after the administration of batroxobin. There was no statistical difference in the median age of the patients in the non-hypofibrinogenemia and hypofibrinogenemia groups (72.0 vs. 74.0 years, respectively). The patients in the hypofibrinogenemia group showed a higher rate of intensive care unit (ICU) admission (11.1% vs.22.7%; P=0.041) and tended to have more massive hemoptysis than those in the non-hyperfibrinogenemia group (23.1% vs. 36.0%; P=0.068). The patients in the hypofibrinogenemia group further showed a higher requirement for transfusion (10.2% vs. 38.7%; P<0.000) than those in the non-hyperfibrinogenemia group.Low levels of baseline plasma fibrinogen and a prolonged and higher total dose of batroxobin were associated with the development of acquired hypofibrinogenemia. Acquired hypofibrinogenemia was associated with increased 30-day mortality [hazard ratio (HR), 4.164; 95% confidence interval (CI), 1.318-13.157]. Conclusions:The plasma fibrinogen levels in patients who were administered batroxobin for hemoptysis should be monitored, and batroxobin should be discontinued if hypofibrinogenemia occurs.

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