Management of endobronchial hemorrhage during cardiopulmonary bypass

Massive endobronchial bleeding during cardiopulmonary bypass was encountered in one patient following pulmonary embolectomy and in another following an elective aorta-coronary bypass procedure. Successful management of this complication necessitates control of ventilation by prolonging cardiopulmonary bypass to ensure adequate oxygenation, suctioning the airway to clear blood from the major tracheobronchial tree, and immediately instituting 20 cm H2O of positive end-expiratory pressure (PEEP) to control endobronchial bleeding.