Management of severe hemoptysis

Parrot, Antoine; Tavolaro, Sebastian; Voiriot, Guillaume; Canellas, Antony; Assouad, Jalal; Cadranel, Jacques; Fartoukh, Muriel

doi:10.1080/17476348.2018.1507737

Cited by 18 publications

(40 citation statements)

References 83 publications

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“…However, this finding may not be accurate in some countries with higher socioeconomic levels [ 7 ]. Socioeconomic level may not be the only important factor as tuberculosis remains a frequent cause of significant haemoptysis in certain countries with a relatively high socioeconomic level [ 3 , 8 , 9 ]. Other frequent causes of moderate-to-severe haemoptysis reported are bronchiectasis, lung cancer, lower respiratory tract infections and mycetomas [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Aetiology, diagnosis and treatment of moderate-to-severe haemoptysis in a North American academic centre

2020

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Significant haemoptysis is a frightening event for patients and clinicians alike. There is a paucity of contemporary literature on the subject.A retrospective analysis of hospitalisations for haemoptysis of more than 50 mL·day−1 in a tertiary referral centre during a 5-year period was performed. Patient's characteristics, haemoptysis aetiology, management and outcome were individually recorded. The aim of this study was to detail the causes of moderate (50–200 mL·day−1) to severe (>200 mL·day−1) haemoptysis along with the diagnostic measures and treatment options used in their management in a 21st century, tertiary-care North American centre.A total of 165 hospitalisations for moderate-to-severe haemoptysis were included in the analysis. Lung cancer (30.3%) and bronchiectasis (27.9%) proved to be most frequent aetiologies. Computed tomography (CT) imaging and bronchoscopy were complementary in identifying the source of bleeding. Bronchial artery embolisation (BAE) was the most common treatment approach (61.8%) and resulted in initial bleeding control in 73.5% of cases. In-hospital mortality was 13.9%, varying from 3.3% in the moderate group to 24.7% in the severe group. Despite being the favoured approach in patients with more severe bleeding, initial BAE therapy was associated with a trend towards lower mortality compared to initial non-BAE therapy.In summary, lung cancer and bronchiectasis were the main causes of moderate-to-severe haemoptysis in our population, CT and bronchoscopy are complementary in identifying the source of bleeding, bleeding volume is associated with outcomes and BAE is a key management tool.

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Section: Introductionmentioning

confidence: 99%

“…Mortality rates for severe haemoptysis are historically reported to be exceeding 50% when not managed aggressively [ 8 ]. In recent cohorts of severe haemoptysis in France [ 3 ] and Singapore [ 16 ], in-hospital mortality rates between 6% and 13% were observed.…”

Section: Introductionmentioning

confidence: 99%

Aetiology, diagnosis and treatment of moderate-to-severe haemoptysis in a North American academic centre

2020

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“…Since the first introduction in 1974 by Remy et al [24], BAE has been known as an effective option for the control of massive and recurrent hemoptysis until now [6,7,25,26]. Identification of the source and site of the bleeding before BAE is critical to completely search for all abnormal vessels, which can improve the procedural efficiency.…”

Section: Discussionmentioning

confidence: 99%

Value of multidetector computed tomography angiography before bronchial artery embolization in hemoptysis management and early recurrence prediction: a prospective study

Phạm

et al. 2020

BMC Pulm Med

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Background: Multidetector computed tomography (MDCT) angiography is a useful examination to detect the source of the bleeding in patients with hemoptysis. The aim of the study was to prospectively evaluate the role and clinical efficacy of MDCT angiography before bronchial artery embolization (BAE) for the management of hemoptysis, and to investigate the predictors of early recurrence. Methods: It is a double-center study which included 57 hemoptysis patients undergoing MDCT angiography prior to BAE from August 2019 to July 2020. A prospective analysis of culprit arteries detected by MDCT angiography allowed an evaluation of the role of this technique. A follow-up was done to assess the efficacy of BAE with preprocedural MDCT angiography and to explore the risk factors of early recurrent hemoptysis. Results: The accuracy of MDCT angiography in the identification of culprit arteries was as high as 97.5%. The average number of total culprit arteries per patient was 2.75 ± 1.73. Among which, the average numbers of culprit ectopic bronchial arteries (BAs) and non-bronchial systemic arteries (NBSAs) per patient were 0.21 ± 0.41 and 1.04 ± 1.57, respectively. The immediate clinical success rate, total hemoptysis recurrence rate, and early hemoptysis recurrence rate of BAE following MDCT angiography were 94.7, 18.5, 16.7%, respectively. Aspergilloma (HR = 6.63, 95% CI: 1.31-33.60, p = 0.022) was associated with an increase in the risk of early recurrence. Conclusions: MDCT angiography should be performed before BAE for the management of hemoptysis. Aspergilloma was an independent predictor for early recurrence.

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“…Since the rst introduction in 1974 by Remy et al [24], BAE has been known as an effective option for the control of massive and recurrent hemoptysis until now [6,7,25,26]. Identi cation of the source and site of the bleeding before BAE is critical to completely search for all abnormal vessels, which can improve the procedural e ciency.…”

Section: Discussionmentioning

confidence: 99%

Value of multidetector computed tomography angiography before bronchial artery embolization in hemoptysis management and early recurrence prediction: a prospective study

Le¹,

Phạm

et al. 2020

Preprint

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Background: Multidetector computed tomography (MDCT) angiography is an useful examination to detect the source of the bleeding in patients with hemoptysis. The aim of the study was to prospectively evaluate the role and clinical efficacy of MDCT angiography before bronchial artery embolization (BAE) for the management of hemoptysis, and to investigate the predictors of early recurrence.Methods: It is a double-center study which included 57 hemoptysis patients undergoing MDCT angiography prior to BAE from August 2019 to July 2020. A prospective analysis of culprit arteries detected by MDCT angiography allowed an evaluation of the role of this technique. A follow-up was done to assess the efficacy of BAE with preprocedural MDCT angiography and to explore the risk factors of early recurrent hemoptysis.Results: The accuracy of MDCT angiography in the identification of culprit arteries was as high as 97.5%. The average number of total culprit arteries per patient was 2.75 1.73. Among which, the average numbers of culprit ectopic bronchial arteries (BAs) and non-bronchial systemic arteries (NBSAs) per patient were 0.21 0.41 and 1.04 1.57, respectively. The immediate clinical success rate, total hemoptysis recurrence rate, and early hemoptysis recurrence rate of BAE following MDCT angiography were 94.7%, 18.5%, 16.7%, respectively. Aspergilloma (HR = 6.63, 95% CI: 1.31-33.60, p = 0.022) was associated with an increase in the risk of early recurrence.Conclusions: MDCT angiography should be performed before BAE for the management of hemoptysis. Aspergilloma was an independent predictor for early recurrence.

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Management of severe hemoptysis

Cited by 18 publications

References 83 publications

Aetiology, diagnosis and treatment of moderate-to-severe haemoptysis in a North American academic centre

Aetiology, diagnosis and treatment of moderate-to-severe haemoptysis in a North American academic centre

Value of multidetector computed tomography angiography before bronchial artery embolization in hemoptysis management and early recurrence prediction: a prospective study

Value of multidetector computed tomography angiography before bronchial artery embolization in hemoptysis management and early recurrence prediction: a prospective study

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