An integrated approach to diagnosis and management of severe haemoptysis in patients admitted to the intensive care unit: a case series from a referral centre

Fartoukh, Muriel; Khalil, Antoine; Louis, Lawrence H.; Carette, Marie-France; Bazelly, B; Cadranel, Jacques; Mayaud, C; Parrot, Antoine

doi:10.1186/1465-9921-8-11

Cited by 87 publications

(69 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Among these, chronic alcoholism remained the only factor independently associated with in-hospital mortality after adjustment for the other prognostic factors. In-hospital mortality was also strongly related to the cause, especially cancer and aspergillosis, and to the source of hemoptysis, as previously reported [5,10,11,[30][31][32][33][34][35][36] .…”

Section: Discussionsupporting

confidence: 54%

“…Since the threshold varies extensively across the literature, some authors recommend that life-threatening hemoptysis should be defined as any hemoptysis that is 1 100 ml in 24 h (the smallest amount reported in the literature to threaten life) or causes abnormal gas exchange, airway obstruction, or hemodynamic instability [3,4] . However, the situation wherein patients with hemoptysis are mechanically ventilated occurs in only 10-20% of cases [5] . Comorbid conditions (bleeding diathesis, poor pulmonary reserve) have also been considered as additional poor prognostic factors in selected populations of patients [6][7][8][9] .…”

mentioning

confidence: 99%

“…Comorbid conditions (bleeding diathesis, poor pulmonary reserve) have also been considered as additional poor prognostic factors in selected populations of patients [6][7][8][9] . Both the cause [5,8,[10][11][12] and the source [12,13] of hemoptysis should also be integrated in the reasoning process of the severity assessment of hemoptysis.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Early Prediction of In-Hospital Mortality of Patients with Hemoptysis: An Approach to Defining Severe Hemoptysis

et al. 2011

Self Cite

View full text Add to dashboard Cite

chanical ventilation at referral predicted independently mortality. The model showed good concordance between predicted and observed probabilities of death and good discrimination (receiver operating characteristic curve area 0.87; 95% CI 0.82-0.92). The model-based score (chronic alcoholism, pulmonary artery involvement, and radiographic patterns, 1 point each; cancer, aspergillosis, and mechanical ventilation, 2 points each) predicted the probability of death as follows: score 0, 1%; score 1, 2%; score 2, 6%; score 3, 16%; score 4, 34%; score 5, 58%; score 6, 79%, and score 7, 91%. Conclusions: Our results provide useful information about the short-term prognosis of patients with hemoptysis, which could help design therapeutic approaches and management plans according to the risk of in-hospital mortality.

show abstract

Section: Discussionsupporting

confidence: 54%

mentioning

confidence: 99%

See 1 more Smart Citation

Early Prediction of In-Hospital Mortality of Patients with Hemoptysis: An Approach to Defining Severe Hemoptysis

et al. 2011

Self Cite

View full text Add to dashboard Cite

show abstract

“…To control active bleeding, all patients received conservative measures as described elsewhere [17], including systemic terlipressin in 57 (46%) and bronchoscopy in 34 (27%) patients (36 procedures), combining blood aspiration, local instillation of cold saline lavage (n=21) and local vasoconstrictor administration (n=29). In one case, balloon bronchial tamponade was employed.…”

Section: Haemoptysis Characteristicsmentioning

confidence: 99%

Severe haemoptysis in patients with nonsmall cell lung carcinoma

et al. 2014

Self Cite

View full text Add to dashboard Cite

Severe haemoptysis due to nonsmall cell lung cancer (NSCLC) is considered a grim condition, and there is still scarce data on its characteristics and outcome, despite new imaging and treatment modalities. This retrospective study sought to describe the clinical characteristics, pathophysiology and outcome of NSCLC-related haemoptysis.We included 125 consecutive patients with severe haemoptysis (>100 mL) at admission, 65 (52%) exhibiting squamous cell carcinoma. Tumour cavitation/necrosis was reported in 26 (21%) patients. 52 patients had received anticancer treatment, but none had received anti-angiogenic agents.Severe haemoptysis was related mainly to the bronchial artery (82%), and major pulmonary artery involvement was rare (6.4%). Interventional radiology was performed in 102 patients. Bleeding cessation was achieved in 108 (87%) out of 125 patients. The overall in-hospital and 1-year survival rates were 69% and 30%, respectively. Performance status (PS) ⩾2 (OR 3.6, 95% CI 1.3-9.6), advanced stage (OR 8.6, 95% CI 2-37) and mechanical ventilation (OR 13, 95% CI 4.5-36) were independent predictors of in-hospital mortality. Performance status ⩾2 (hazard ratio (HR) 2.4, 95% CI 1.5-3.7), advanced stage (HR 4, 95% CI 2.1-7.7), cancer progression (HR 2, 95% CI 1.01-2.7) and cavitation/necrosis (HR 1.7, 95% CI 1.21-3.2) were independently associated with 1-year mortality.Management of severe haemoptysis related to NSCLC should be improved, given our observed survival rates after hospital discharge. @ERSpublications NSCLC-related haemoptysis should not be considered dismissively; its management is still suboptimal

show abstract

“…Bronchial artery embolization (BAE) is commonly used in patients with massive hemoptysis, however, it should be cautiously carried out to prevent vascular complications associated with the procedure (1). We report herein a case of multiple infarctions in the posterior circulation which were exhibited as occipital blindness and ataxia complicating BAE.…”

Section: Introductionmentioning

confidence: 99%

Cortical Blindness and Ataxia Complicating Bronchial Artery Embolization for Severe Hemoptysis

et al. 2010

View full text Add to dashboard Cite

Complications of bronchial artery embolization (BAE) are uncommon. A 37-year-old patient with pulmonary tuberculosis received bronchial artery embolization because of severe hemoptysis. The bilateral bronchial arteries and left internal mammary artery were embolized using a gelatin sponge, and the patient exhibited occipital blindness and ataxia after the second BAE. The dissolvable gelatin sponge possibly entered the posterior circulation, resulting in the multiple infarctions in the bilateral occipital lobes and cerebellum. Because of the bad prognosis and the difficulty for curability, this kind of complication should be recognized in a timely manner and carefully avoided by the interventional radiologists carrying out the BAE.

show abstract

An integrated approach to diagnosis and management of severe haemoptysis in patients admitted to the intensive care unit: a case series from a referral centre

Cited by 87 publications

References 20 publications

Early Prediction of In-Hospital Mortality of Patients with Hemoptysis: An Approach to Defining Severe Hemoptysis

Early Prediction of In-Hospital Mortality of Patients with Hemoptysis: An Approach to Defining Severe Hemoptysis

Severe haemoptysis in patients with nonsmall cell lung carcinoma

Cortical Blindness and Ataxia Complicating Bronchial Artery Embolization for Severe Hemoptysis

Contact Info

Product

Resources

About