Management of massive hemoptysis in a thoracic surgical unit

Endo, Shunsuke; Otani, Shinichi; Saito, Noriko; Hasegawa, Tsuyoshi; Kanai, Yoshihiko; Satô, Yukio; Sohara, Yasunori

doi:10.1016/s1010-7940(03)00008-3

Cited by 56 publications

(39 citation statements)

References 22 publications

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“…the definition of massive hemoptysis varies widely in the literature (over 200 or 600 ml per day); however, hemoptysis should be evaluated not in terms of the volume of bleeding but from the standpoint of life-threatening airway obstruction and asphyxiation [1,4]. the amount of the bleeding is a significant criteria.…”

Section: Discussionmentioning

confidence: 99%

Response of Complex Undefined Hypereosinophilic Syndrome to Treatment with Imatinib

Yılmaz

Kaynar

Tutar

et al. 2016

Turk Toraks Dergisi

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OBJECTIVES:The objective was to describe changing patterns of etiological factors and treatment modalities for massive hemoptysis. MATERIAL AND METHODS:From January 2008-December 2012, the medical records of 58 massive hemoptysis patients were reviewed. RESULTS:Fifty-eight patients, 44 were men (75.9%) and 14 were women (24.1%), with a mean age of 51.4 years (range= 19-84 years), were divided into three groups; surgical management (n= 37, 63.8%), conservative management (n= 14, 24.1%) and bronchial artery embolization (n= 6, 10.4%). One case (1.7%) had combined treatment modality; bronchial artery embolization was followed by surgical resection. Anatomical lung resections were the most preferred resection type in the surgical management group (n= 34, 91.9%). The most common etiological factor was bronchiectasis (n= 19, 32.8%); followed by bronchial cancer (n= 14, 24.1%). The duration of hospitalization in the surgical management group was 11.4 days (range= 4-24); whereas in the bronchial artery embolization group, hospitalization was only four days (range= 2-7) (p< 0.01). Prolonged air leak (n= 7; 18.9%) was the most common complication in the surgical management group. CONCLUSION:We emphasize that bronchiectasis was leading cause of massive hemoptysis. Surgical treatment remains the definitive therapy in the management of massive hemoptysis with decreased mortality rates over decades; whereas bronchial artery embolization is an effective therapeutic tool.

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Section: Discussionmentioning

confidence: 99%

Response of Complex Undefined Hypereosinophilic Syndrome to Treatment with Imatinib

Yılmaz

Kaynar

Tutar

et al. 2016

Turk Toraks Dergisi

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“…1,2,4) As an alternative, hemoptysis should be classified due to its severeness and life-threatening circumstance instead of its quantity. In our series of patients undergoing lung resection for life-threatening hemoptysis, 17 (54.8%) had a bleeding amount of 200-600 ml/day, and the rest 14 (45.2%) had an amount over 600 ml/day.…”

Section: Discussionmentioning

confidence: 99%

“…Morbidity and mortality rates are found to be higher in emergency cases than elective pulmonary resections for hemoptysis. 1,4,11) In patients necessitating urgent resections, the pulmonary reserve is usually compromised due to aspiration, and the resection which can be extensive, is performed during the bleeding. Andrejak, et al have reported a series of 111 (13.6%) lung resections for severe hemoptysis out of 813 cases admitted to ICU, 11) in accordance to our surgery rate of 15.8% (31/208).…”

Section: Discussionmentioning

confidence: 99%

“…Massive hemoptysis is associated with a mortality rate over 50%. 1,2) Several therapeutic strategies have been applied with variable results. Overall mortality, especially after emergent surgery, is still high, ranging from 10% to 38%.…”

Section: Introductionmentioning

confidence: 99%

“…Overall mortality, especially after emergent surgery, is still high, ranging from 10% to 38%. 1) A new multidisiplinary approach associating the intensive care physician, the chest physician, the radiologist and the thoracic surgeon enables to lower the mortality rate. In this multidisiplinary approach, the place of surgical treatment among medical treatment and bronchial artery embolization is not obvious.…”

Section: Introductionmentioning

confidence: 99%

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Pulmonary Resection in the Treatment of Life-Threatening Hemoptysis

Kıral

Evman

Tezel

et al. 2015

ATCS

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Purpose: Massive hemoptysis is a life threatening situation with high mortality rates. Surgery is effective, however generally an avoided treatment. We report our experience with patients undergoing lung resection for life-threatening hemoptysis. Methods: Records of all surgically treated patients for hemoptysis between June 2009 and June 2012 were reviewed and analyzed retrospectively. Results: Anatomical resection was performed on 31 (15.3%) patients out of 203 patients referred to our intensive care unit for life-threatening hemoptysis. 25 (80.6%) were male and six (19.4%) were female; with mean age of 46.4 ± 13.7 (21-77). Pneumonectomy was performed in four (12.9%), lobectomy in 24 (77.4%), segmentectomy in two (6.5%) and bilobectomy in one case. Postoperative complications developed in eight (25.8%), and mortality was observed in two (6.5%) patients. Etiology was bronchiectasis in 13 (42.0%), tuberculosis in eight (25.8%), carcinoma in four (12.9%), aspergilloma in four (12.9%), hydatid cyst in one (3.2%) and lung abscess in one (3.2%) of the cases. Conclusions: Although lung resection in the treatment of massive hemoptysis is accompanied with high morbidity and mortality rates, surgery is the only permanent curative modality. Acceptable results can be achived in the company of a multidisciplinary approach, through avoidance of pneumonectomy and urgent surgery.

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Cardiovascular and Thoracic Surgery

Antevil

Brown

2012

Surgical Critical Care and Emergency Surgery

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Management of massive hemoptysis in a thoracic surgical unit

Cited by 56 publications

References 22 publications

Response of Complex Undefined Hypereosinophilic Syndrome to Treatment with Imatinib

Response of Complex Undefined Hypereosinophilic Syndrome to Treatment with Imatinib

Pulmonary Resection in the Treatment of Life-Threatening Hemoptysis

Cardiovascular and Thoracic Surgery

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