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Management of severe hemoptysis
Antoine Parrot1, Sebastian Tavolaro2,3, Guillaume Voiriot3,4
1a Service de Pneumologie , AP-HP, Hôpitaux Universitaires de l'Est Parisien, Pôle TVAR, Hôpital Tenon , Paris , France.
Expert Review of Respiratory Medicine
|September 11, 2018
Summary
Severe hemoptysis (SH) is a rare but life-threatening condition. Prompt diagnosis with multidetector computed tomography angiography (MDCTA) and interventional radiology are crucial for effective management and improved survival rates.
Area of Science:
- Pulmonology
- Radiology
- Interventional Cardiology
Background:
- Severe hemoptysis (SH) carries a high mortality rate (>50%) if not managed promptly.
- Accurate diagnosis and timely intervention are critical for patient outcomes.
Purpose of the Study:
- To review current epidemiological data on SH.
- To evaluate the roles of multidetector computed tomography angiography (MDCTA) and fiberoptic bronchoscopy (FOB) in SH management.
- To assess the efficacy of existing treatment modalities.
Main Methods:
- Review of recent epidemiological studies on SH.
- Analysis of the diagnostic capabilities of MDCTA for identifying bleeding sources.
- Evaluation of the therapeutic applications of FOB, interventional radiology, and surgical options.
Main Results:
- MDCTA is essential for precise localization, etiological determination, and understanding the mechanism of bleeding in SH.
- Fiberoptic bronchoscopy (FOB) may be deferred unless immediate local control is necessary.
- Interventional radiology, including bronchial arteriography targeting both bronchial and non-bronchial arteries, is the cornerstone of emergency treatment.
- Surgery is reserved for operable patients with persistent bleeding sources.
Conclusions:
- MDCTA plays a pivotal role in the diagnostic workup of SH.
- Interventional radiology offers effective emergency management for SH.
- A multidisciplinary approach integrating imaging, interventional procedures, and surgery is vital for managing severe hemoptysis.
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