Three years experience with a new balloon catheter for the management of haemoptysis

Abstract

For the management of severe haemoptysis we have developed a double-lumen, bronchus-blocking catheter that can be introduced through the working channel of a standard fibrebronchoscope. We wondered whether this catheter would be suitable to control pulmonary haemorrhage in clinical practice. Over a period of 36 months, 30 of these catheters were used in 27 patients with moderate and massive pulmonary bleeding from various lesions. Underlying diseases were: malignancies (11), vascular deformities (5), tuberculosis (4), silicosis (2), carcinoids (2), silicosis (2), endometriosis (1), bronchiectasis (1). In 26 cases, the transbronchoscopic balloon tamponade was successful. In one patient, tumour growth close to the carina prevented securing of the balloon and double-lumen tube intubation was required. There were only minor complications attributable to the balloon. With the catheter in place for up to seven days, patients underwent surgery, received radiation, chemotherapy, drug treatment or bronchial arterial embolization. In conclusion, we found this double-lumen, bronchus-blocking device safe and the technique practicable to control pulmonary haemorrhage.

Surgical Indications for Treatment of Pulmonary Tuberculosis

“…The site of bleeding should first be localized through bronchoscopy, avoiding passage of blood into the contralateral lung. This procedure can be performed by bronchial blockage and embolization of the bronchial arteries before scheduling an operation [25,26]. If the patient fails to respond to conservative measures, emergency surgical treatment is undertaken if the situation may result in severe morbidity or mortality.…”