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Massive Hemoptysis

  • Frank Genese
  • Norman Adair
  • David L. Bowton
  • Andrew M. NamenEmail author
Chapter
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Abstract

Massive hemoptysis occurs in up to 10% of patients hospitalized for hemoptysis, and is associated with significant morbidity and mortality. Risk factors have been recognized to aid in identification of patients at highest risk of mortality. The initial volume of bleeding, respiratory compromise and hemodynamic status should dictate the diagnostic and treatment approach. An ABC (Airway, Blood loss, and Clinical features) mnemonic can assist with rapid assessment of the unstable patient. Based on the initial survey, one considers decisions of airway protection; isolating the affected lung; ICU transfer; radiographic and bronchoscopic evaluation; and interventional radiographic, bronchoscopic and/or surgical treatment. We present an illustrative case of massive hemoptysis and a suggested approach to care.

Keywords

Hemoptysis Bronchoscopy Computed tomography Embolization Artificial airway ICU Interventional radiology 

Abbreviations

ACR

American College of Radiology

ADH

Anti diuretic hormone

APC

Argon plasma coagulation

BAE

Bronchial artery embolization

DTA

Descending thoracic aorta

EPI

Epinephrine

ICU

Intensive care unit

IR

Interventional radiology

LLL

Left lower lobe

MDCT

Multidetector computed tomography

RLL

Right lower lobe

RUL

Right upper lobe

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Frank Genese
    • 1
  • Norman Adair
    • 1
  • David L. Bowton
    • 2
  • Andrew M. Namen
    • 1
    Email author
  1. 1.Department of Internal Medicine Division of Pulmonary, Critical Care and Allergy and ImmunologyWake Forest University School of MedicineWinston-SalemUSA
  2. 2.Department of AnesthesiologyWake Forest University School of MedicineWinston-SalemUSA

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