Abstract
Haemoptysis is a common symptom in clinical practice, which requires further investigation. Fortunately, massive haemoptysis only accounts for a small proportion of these episodes. It is a medical emergency that carries a high mortality rate. There are no agreed management guidelines. This review discusses proposed methods of resuscitation as well as outlining a diagnostic algorithm and discusses treatments including bronchial artery embolization, endobronchial therapy, surgery and medical therapies.
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References
- Amirana M. An aggressive surgical approach to significant hemoptysis in patients with pulmonary tuberculosis. The American review of respiratory disease. 1968; 97: 187–192.
- Corey R, Hla KM. Major and Massive Hemoptysis - Reassessment of Conservative Management. American Journal of the Medical Sciences. 1987; 294: 301–309.
- Håkanson E, Konstantinov IE, Fransson SG., Svedjeholm R. Management of life threatening haemoptysis. British Journal of Anaesthesia. 2002; 88: 291–295.
- Ibrahim WH. Massive haemoptysis: the definition should be revised. European Respiratory Journal. 2008; 32: 1131–1132.
- Crocco JA, Rooney JJ, Fankushen DS, DiBenedetto RJ, Lyons HA. Massive hemoptysis. Arch Intern Med. 1968; 121: 495–498.
- Cauldwell EW, Siekert RG, Lininger RE, et al. The bronchial arteries: an anatomic study of 150 human cadavers. Surg Gynecol Obstet. 1948; 86: 395–412.
- Marshall TJ, Jackson JE. Vascular intervention in the thorax: bronchial artery embolization for haemoptysis. European Radiology. 1997; 7: 1221–1227.
- Jean-Baptiste E. Clinical assessment and management of massive hemoptysis. Crit Care Med. 2000; 28: 1647.
- Mcdonald DM. Angiogenesis and Remodeling of Airway Vasculature in Chronic Inflammation. Am J Respir Crit Care Med. 2001; 164: S39–S45.
- Hirshberg B, Biran I, Glazer M, Kramer MR. Hemoptysis: Etiology, evaluation, and outcome in a tertiary referral hospital. Chest. 1997; 112: 440–444.
- Reisz G, Stevens D, Boutwell C, Nair V. The causes of hemoptysis revisited. A review of the etiologies of hemoptysis between 1986 and 1995. Mo Med. 1997; 94: 633–635.
- Santiago S, Tobias J, Williams AJ. A Reappraisal of the Causes of Hemoptysis. Arch Intern Med. 1991; 151: 2449–2451.
- The Resuscitation Guidelines 2010. The Resuscitation council (UK). 2010.
- Marshall TJ, Flower CDR, Jackson JE. The role of radiology in the investigation and management of patients with haemoptysis. Clinical Radiology. 1996; 51: 391–400.
- Herth F, Ernst A, Becker HD. Long-term Outcome and Lung Cancer Incidence in Patients With Hemoptysis of Unknown Origin* . Chest. 2001; 120: 1592–1594.
- Bidwell JL, Pachner RW. Hemoptysis: Diagnosis and mangement. Am Fam Physician. 2005; 72: 1253–1260.
- National Institute for Health and Clinical Excellence. The Diagnosis and Treatment of Lung Cancer CG24. London: National Institute for Health and Clinical Excellence. 2005.
- Poe RH, Kallay MC, Israel RH et al. Utility of Fiberoptic Bronchoscopy in Patients with Hemoptysis and a Nonlocalizing Chest Roentgenogram. Chest. 1988; 93: 70–75.
- Sakr L, Dutau H. Massive haemoptysis: An update on role of bronscopy in diagnosis and management. Respiration. 201; 80: 38–58.
- Haponik EF, Fein A, Chin R. Managing Life-Threatening Hemoptysis* . Chest. 2000; 118: 1431–1435.
- Gourin A, Garzon AA. Control of hemorrhage in emergency pulmonary resection for massive hemoptysis. Chest. 1975; 68: 120–121.
- Klein U, Karzai W, Bloos F et al. Role of fiberoptic bronchoscopy in conjunction with the use of double-lumen tubes for thoracic anesthesia - A prospective study. Anesthesiology. 1998; 88: 346–350.
- Lordan JL, Gascoigne A, Corris PA. The pulmonary physician in critical care. Illustrative case 7: Assessment and management of massive haemoptysis. Thorax. 2003; 58: 814–819.
- American College of Surgeons Committee on Trauma: Advanced Trauma Life Support Course Manual. Chicago, Ill. American College of Surgeons. 1997.
- Remy-Jardin M, Bouaziz N, Dumont P, Brillet PY, Bruzzi J, Remy J. Bronchial and Nonbronchial Systemic Arteries at Multi - Detector Row CT Angiography: Comparison with Conventional Angiography1. Radiology. 2004; 233: 741–749.
- Flume PA, Mogayzel PJ, Jr., Robinson KA et al. Cystic Fibrosis Pulmonary Guidelines: Pulmonary Complications: Hemoptysis and Pneumothorax. Am J Respir Crit Care Med. 2010; 182: 298–306.
- Pasteur MC, Bilton D, Hill AT. British Thoracic Society guideline for non-CFbronchiectasis. Thorax. 2010; 65: i1–i58.
- Cahill BC, Ingbar DH. Massive Hemoptysis - Assessment and Management. Clinics in Chest Medicine. 1994;15: 147–168.
- Conlan AA, Hurwitz SS. Management of Massive Hemoptysis with the Rigid Bronchoscope and Cold Saline Lavage. Thorax. 1980; 35:901–904.
- Tsukamoto T, Sasaki H, Nakamura H. Treatment of Hemoptysis Patients by Thrombin and Fibrinogen-Thrombin Infusion Therapy Using A Fiberoptic Bronchoscope. Chest. 1989; 96: 473–476.
- Solomonov A, Fruchter O, Zuckerman T, Brenner B, Yigla M. Pulmonary hemorrhage: A novel mode of therapy. Respiratory Medicine. 2009; 103: 1196–1200.
- Hiebert CA. Balloon Catheter Control of Life-Threatening Hemoptysis. Chest. 1974; 66: 308–309.
- Dumon JF, Reboud E, Garbe L, Aucomte F, Meric B. Treatment of Tracheobronchial Lesions by Laser Photoresection. Chest. 1982; 81: 278–284.
- Chun JY, Morgan R, Belli AM. Radiological Management of Hemoptysis: A Comprehensive Review of Diagnostic Imaging and Bronchial Arterial Embolization. CardioVascular and Interventional Radiology. 2010; 33: 240–250.
- Remy J, Voisin C, DC, ea. Traitement des hémoptysies par embolisation de la circulation systémique. Ann Radiol (Paris). 1974; 17: 5–16.
- White RI. Bronchial Artery Embolotherapy for Control of Acute Hemoptysis. Chest. 1999; 115: 912–915.
- Chan A, Louie S, Leslie K, Juarez M, Albertson T. Cutting Edge Issues in Goodpasture's Disease. Clinical Reviews in Allergy and Immunology. 2011; 1–12.
- Wong LTK, Lillquist YP, Culham G, Dejong BP, Davidson AGF. Treatment of recurrent hemoptysis in a child with cystic fibrosis by repeated bronchial artery embolizations and long-term tranexamic acid. Pediatric Pulmonology. 1996; 22: 275–279.
- Bilton D, Webb AK, Foster H, Mulvenna P, Dodd M. Life threatening haemoptysis in cystic fibrosis: an alternative therapeutic approach. Thorax. 1990; 45: 975–976.
