Abstract
Hemoptysis is usually a symptom of cardiopulmonary disease and is generally not in itself associated with death. A blood loss into the tracheobronchial tree of 600 ml in 24 hours or at a rate that poses a threat to life is referred to as massive hemoptysis. Hypervascularity within the bronchial circulation, usually associated with diffuse inflammatory disease of the lung, is common in patients with massive hemoptysis. Management should be directed at maintenance of oxygenation and localization of the source of bleeding. Temporizing maneuvers such as iced saline lavage, intravenous administration of vasopressin, endobronchial tamponade and bronchial artery embolization will often stabilize the patient in preparation for definitive surgery. Such a sequential plan of management may result in a 50% reduction in the rate of death from massive hemoptysis, which is otherwise 50% to 100%.
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Selected References
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- AMANN R., WOLFF R. [Protamine sulfate as a hemostyptic in lung hemorrhages]. Klin Wochenschr. 1959 Dec 15;37:1279–1279. doi: 10.1007/BF01488546. [DOI] [PubMed] [Google Scholar]
- Bobrowitz I. D., Ramakrishna S., Shim Y. S. Comparison of medical v surgical treatment of major hemoptysis. Arch Intern Med. 1983 Jul;143(7):1343–1346. [PubMed] [Google Scholar]
- Conlan A. A., Hurwitz S. S., Krige L., Nicolaou N., Pool R. Massive hemoptysis. Review of 123 cases. J Thorac Cardiovasc Surg. 1983 Jan;85(1):120–124. [PubMed] [Google Scholar]
- Conlan A. A., Hurwitz S. S. Management of massive haemoptysis with the rigid bronchoscope and cold saline lavage. Thorax. 1980 Dec;35(12):901–904. doi: 10.1136/thx.35.12.901. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Crocco J. A., Rooney J. J., Fankushen D. S., DiBenedetto R. J., Lyons H. A. Massive hemoptysis. Arch Intern Med. 1968 Jun;121(6):495–498. [PubMed] [Google Scholar]
- Garzon A. A., Cerruti M. M., Golding M. E. Exsanguinating hemoptysis. J Thorac Cardiovasc Surg. 1982 Dec;84(6):829–833. [PubMed] [Google Scholar]
- Garzon A. A., Gourin A. Surgical management of massive hemoptysis. A ten-year experience. Ann Surg. 1978 Mar;187(3):267–271. doi: 10.1097/00000658-197803000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gourin A., Garzon A. A. Control of hemorrhage in emergency pulmonary resection for massive hemoptysis. Chest. 1975 Jul;68(1):120–121. doi: 10.1378/chest.68.1.120. [DOI] [PubMed] [Google Scholar]
- Magee G., Williams M. H., Jr Treatment of massive hemoptysis with intravenous pitressin. Lung. 1982;160(3):165–169. doi: 10.1007/BF02719288. [DOI] [PubMed] [Google Scholar]
- Magilligan D. J., Jr, Ravipati S., Zayat P., Shetty P. C., Bower G., Kvale P. Massive hemoptysis: control by transcatheter bronchial artery embolization. Ann Thorac Surg. 1981 Oct;32(4):392–400. doi: 10.1016/s0003-4975(10)61762-6. [DOI] [PubMed] [Google Scholar]
- Naar C. A., Soong J., Clore F., Hawkins I. F., Jr Control of massive hemoptysis by bronchial artery embolization with absolute alcohol. AJR Am J Roentgenol. 1983 Feb;140(2):271–272. doi: 10.2214/ajr.140.2.271. [DOI] [PubMed] [Google Scholar]
- POPPER J. The use of premarin IV in hemoptysis. Dis Chest. 1960 Jun;37:659–660. doi: 10.1378/chest.37.6.659. [DOI] [PubMed] [Google Scholar]
- Saw E. C., Gottlieb L. S., Yokoyama T., Lee B. C. Flexible fiberoptic bronchoscopy and endobronchial tamponade in the management of massive hemoptysis. Chest. 1976 Nov;70(5):589–591. doi: 10.1378/chest.70.5.589. [DOI] [PubMed] [Google Scholar]
- TRIMBLE H. G., WOOD J. R. Pulmonary hemorrhage: its control by the use of intravenous pituitrin. Dis Chest. 1950 Oct;18(4):345–351. doi: 10.1378/chest.18.4.345. [DOI] [PubMed] [Google Scholar]
- Uflacker R., Kaemmerer A., Neves C., Picon P. D. Management of massive hemoptysis by bronchial artery embolization. Radiology. 1983 Mar;146(3):627–634. doi: 10.1148/radiology.146.3.6828674. [DOI] [PubMed] [Google Scholar]
- Wholey M. H., Chamorro H. A., Rao G., Ford W. B., Miller W. H. Bronchial artery embolization for massive hemoptysis. JAMA. 1976 Nov 29;236(22):2501–2504. [PubMed] [Google Scholar]