Multidisciplinary Management of Life-Threatening Massive Hemoptysis: A 10-Year Experience

Shigemura, Norihisa; Wan, Innes Y P; Yu, Simon C.H.; Wong, Randolph H.L.; Hsin, Michael K.Y.; Thung, Hoi K.; Lee, Tak‐Wai; Wan, Song; Underwood, Malcolm J.; Yim, Anthony P.C.

doi:10.1016/j.athoracsur.2008.11.010

Cited by 116 publications

(83 citation statements)

References 14 publications

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“…Likewise, Shigemura, et al have stated that patients undergoing emergency resections for life-threatening hemoptysis have high morbidity and mortality rates according to patients undergoing preoperative bronchial artery embolization. 12) Overall morbidity rate of our cohort was 25.8%. Despite the high postoperative complication rate seen in pneumonectomy patients, no significant difference was observed between complication rates of pneumonectomy and lesser resections (50.0% vs. 22.2%; P = 0.268), probably due to the unjustification of the low number of our cases.…”

Section: Discussionmentioning

confidence: 71%

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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Section: Discussionmentioning

confidence: 71%

Pulmonary Resection in the Treatment of Life-Threatening Hemoptysis

Kıral

Evman

Tezel

et al. 2015

ATCS

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“…Death due to bleeding is a rare cause of mortality. Massive hemoptysis has a mortality rate of 25-50% in patients who are not treated adequately [2,3]. the anatomical dead space of the tracheobronchial tree is only 200 ml or less.…”

Section: Introductionmentioning

confidence: 99%

“…therefore, expectoration of 200 ml or more of blood over a 24-hour period or bronchial blood loss causing hemodynamic or respiratory compromise can be defined as massive or major hemoptysis [4]. treatment modalities published for massive hemoptysis include conservative medical therapy, surgical therapy (pulmonary resection), endobronchial control measures (balloon tamponade, endobronchial iced saline lavage) and bronchial artery embolization [2,3]. In the late 1970s and at the beginning of 1980s, the most common etiological factor for massive hemoptysis was tuberculosis and surgical management was the prime therapeutic approach with a mortality rate of over 18% [5,6].…”

Section: Introductionmentioning

confidence: 99%

Management of Massive Hemoptysis: Analyses of 58 Patients

Yazicioğlu¹,

Yekeler²,

Yazıcı

et al. 2018

Turk Thorac J

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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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“…2 The risk of death in haemoptysis is due to asphyxiation by flooding of blood into traechobronchial tree rather than exsanaguation and hypovolemia. 3,4 In cases of haemoptysis, the role of B. A. E preceding surgery is not well defined.…”

Section: Introductionmentioning

confidence: 99%