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Hemoptysis

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3. Palliative radiotherapy: superior vena cava obstruction, dyspnea, and hemoptysis

Palliative radiotherapy: superior vena cava obstruction, dyspnea, and hemoptysis CLINICAL PRACTICE GUIDELINE RT-005 Version 1 Palliative Radiotherapy: Superior Vena Cava Obstruction, Dyspnea, and Hemoptysis Effective Date: July, 2016 The recommendations contained in this guideline are a synthesis of currently accepted approaches to management, derived from a review of relevant scientific literature. Clinicians applying these guidelines should, in consultation with the patient, use independent (...) in approximately 20 to 30 percent of patients with lung cancer (6). Cancers which have metastasized to the lung or mediastinum can also cause airway obstruction (7). Hemoptysis, or the expectoration of blood, can range from blood-streaking of sputum to gross blood or clots alone, in the absence of any accompanying sputum. Hemoptysis has a broad differential which includes metastatic cancer to the bronchus or trachea (most commonly from melanoma, breast, colon, or renal cell carcinoma), primary or secondary

2016 CPG Infobase

4. CRACKCast E024 – Hemoptysis

CRACKCast E024 – Hemoptysis CRACKCast E024 - Hemoptysis - CanadiEM CRACKCast E024 – Hemoptysis In , by Adam Thomas January 26, 2017 This episode of CRACKCast covers Rosen’s Chapter 24, Hemoptysis. Hemoptysis has a host of causes ranging from benign to life threatening. This action packed episode covers it all, and will help you manage these potentially intimidating patients on your next shift. Shownotes – Rosen’s in Perspective Expectoration of blood arising from the respiratory tract below (...) the cords Most cases this is a small amount of blood tinged sputum, due to bronchitis 1-5% of patients have massive hemoptysis: >100-600mL of blood in 24 hours (Rosen’s) Can lead to shock, impaired gas exchange, with mortality >80% Uptodate: “In our clinical practice, we define massive hemoptysis as either ≥500 mL of expectorated blood over a 24 hour period or bleeding at a rate ≥100 mL/hour, regardless of whether abnormal gas exchange or hemodynamic instability exists.” Pathophysiology Caused

2017 CandiEM

5. Inhaled Tranexamic Acid for Hemoptysis Treatment: A Randomized Controlled Trial

Inhaled Tranexamic Acid for Hemoptysis Treatment: A Randomized Controlled Trial Tranexamic acid (TA) is an antifibrinolytic drug currently used systemically to control bleeding. To date, there have been no prospective studies of the effectiveness of inhaled TA for the treatment of hemoptysis.The goal of this study was to prospectively assess the effectiveness of TA inhalations (ie, nebulized TA) for hemoptysis treatment.This analysis was a double-blind, randomized controlled trial of treatment (...) with nebulized TA (500 mg tid) vs placebo (normal saline) in patients admitted with hemoptysis of various etiologies. Patients with massive hemoptysis (expectorated blood > 200 mL/24 h) and hemodynamic or respiratory instability were excluded. Mortality and hemoptysis recurrence rate were assessed at 30 days and following 1 year.Forty-seven patients were randomized to receive TA inhalations (n = 25) or normal saline (n = 22). TA was associated with a significantly reduced expectorated blood volume starting

2019 EvidenceUpdates

6. Bronchoscopy to assess patients with hemoptysis: which is the optimal timing? (PubMed)

Bronchoscopy to assess patients with hemoptysis: which is the optimal timing? Bronchoscopy plays a key role to diagnose the etiology, to localize the site, and to identify the sources of the bleeding in patients with hemoptysis, but the ideal timing of an endoscopic examination is still unclear.We performed a secondary analysis of an observational and multicenter study, aimed at evaluating the epidemiology of hemoptysis in Italy and the diagnostic yield of the most frequently prescribed (...) examinations. The aim of the study was to evaluate whether an early bronchoscopy (i.e., performed during active bleeding/≤48 h after hemoptysis stopped) helps localize bleeding (i.e., site, lobe, lung) and increase diagnostic yield in comparison with a delayed examination.Four hundred eighty-six consecutive adult patients (69.2% males; median [IQR] age: 67 [53-76] years) with hemoptysis requiring an etiological diagnosis and undergoing bronchoscopy were recruited. Bleeding focus could be located more

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2019 BMC pulmonary medicine

7. Hypoplasia of the left lung presenting as hemoptysis: A case report. (PubMed)

Hypoplasia of the left lung presenting as hemoptysis: A case report. Congenital pulmonary dysplasia (CPD), a congenital lung anomaly, is a heterogeneous group of developmental disorders with diverse clinical and imaging manifestations, including pulmonary agenesis, pulmonary aplasia, and pulmonary hypoplasia. Patients with CPD always have recurrent respiratory tract infections, dyspnea, and/or wheezing. To the best of the author's knowledge, no case of CPD with mild to moderate hemoptysis has (...) been reported so far. Considering the rarity of this presentation, we herein report a case of hemoptysis caused by CPD.We report on an 11-year-old girl who survived for 11 years with hypoplasia of the left lung without any associated complications except hemoptysis.Left pulmonary hypoplasia.The patient underwent left lower pulmonary lobe resection.The patient recovered favorably after the operation, and no complications were observed. The hemoptysis was controlled and the cough disappeared after

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2019 Medicine

8. Antifibrinolytic Agents for Hemoptysis Management in Adults with Cystic Fibrosis. (PubMed)

Antifibrinolytic Agents for Hemoptysis Management in Adults with Cystic Fibrosis. Hemoptysis is a major cause of morbidity and mortality in patients with cystic fibrosis (CF). Antifibrinolytic agents have demonstrated efficacy in a broad range of bleeding disorders and conditions. We examine use of antifibrinolytic agents to manage hemoptysis in CF. We developed a clinical treatment pathway for inpatient and outpatient use, and report on rates of admission for bleeding before and after (...) implementation.All adult CF patients treated with systemic antifibrinolytic agents over a 54-month period according to the treatment pathway were analyzed. Data collected included demographics, baseline CF-related characteristics, and bleeding and treatment parameters. Effectiveness of the pathway was evaluated via comparison of annualized hemoptysis admission rate before and after pathway enrollment.72 distinct episodes of hemoptysis treated with antifibrinolytic agents were analyzed in a total of 21 adult CF

2019 Chest

9. Bronchovascular injury associated with clinically significant hemoptysis after CT-guided core biopsy of the lung: Radiologic and histopathologic analysis. (PubMed)

Bronchovascular injury associated with clinically significant hemoptysis after CT-guided core biopsy of the lung: Radiologic and histopathologic analysis. To evaluate bronchovascular injuries as the causative occurrence for clinically significant hemoptysis after percutaneous transthoracic needle biopsy (PTNB).We included 111 consecutive patients who experienced hemoptysis after cone beam CT (CBCT)-guided PTNB from January 2014 through January 2017. Clinically significant hemoptysis was defined (...) as hemoptysis causing hemodynamic instability or oxygen desaturation greater than 10% of baseline. The lesion characteristics were evaluated on CT images. The penetration of bronchovascular structures along the trajectory of the introducer needle and potential penetration at the firing of the biopsy gun were assessed on CBCT images. The cutting injury of bronchovascular structures was histopathologically assessed in biopsy specimens. The associated factors for clinically significant hemoptysis were assessed

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2018 PLoS ONE

10. Approach to diagnosis of factitious disorder with unexplained hemoptysis: A case report. (PubMed)

Approach to diagnosis of factitious disorder with unexplained hemoptysis: A case report. Hemoptysis or hematemesis is a common clinical symptom in adults, but is unusually to be observed in children. Hemoptysis can occur with circulatory diseases, injuries, several types of systemic diseases, or systemic factors including factitious disorder (FD), which is difficult to be diagnosed. Here, we report a case of hemoptysis caused by FD to provide a diagnostic flow chart for such kind of disease.An (...) 11-year-old female patient had a history of hemoptysis or hematemesis for 6 months and suffered with paroxysmal syncope for a month.A series of examinations had been launched to evaluate any possible malformation or abnormalities of the patient including fiberoptic bronchoscopy, cardiac catheterization, gastroscopy, nasolaryngoscopy, electrocardiogram, electroencephalogram, and enhanced magnetic resonance image of the paranasal sinus. Several methods had been performed and tried to stop

2019 Medicine

11. Pulmonary artery pseudoaneurysm causing massive hemoptysis in hyperimmunoglobulin E syndrome: a case report. (PubMed)

Pulmonary artery pseudoaneurysm causing massive hemoptysis in hyperimmunoglobulin E syndrome: a case report. Hyperimmunoglobulin E syndrome (HIES) is a rare primary immunodeficiency disorder defined by high serum immunoglobulin E titers that is associated with recurrent respiratory infections, formation of pneumoatoceles, recurrent skin abscesses, and characteristic dental and skeletal abnormalities.We report a case of a 56-year-old male with a history of HIES, cavitary mycetomas, and allergic (...) bronchopulmonary aspergillosis who presented with recurrent massive hemoptysis. Bronchial artery angiography and bronchoscopy failed to identify active hemorrhage, and two embolizations of the bronchial artery did not resolve the bleeding. Subsequently, selective pulmonary artery angiography was conducted that demonstrated a subsegmental pulmonary artery branch pseudoaneurysm with extravasation into an adjacent lung cavity. This was treated successfully with transcatheter embolization.To our knowledge

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2019 BMC pulmonary medicine

12. Algorithms for the management of massive hemoptysis in the acute care setting

Algorithms for the management of massive hemoptysis in the acute care setting Algorithms for the management of massive hemoptysis in the acute care setting Algorithms for the management of massive hemoptysis in the acute care setting Lavenberg JG, Umscheid CA, Mull N Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Lavenberg JG, Umscheid CA, Mull N. Algorithms (...) for the management of massive hemoptysis in the acute care setting. Philadelphia: Center for Evidence-based Practice (CEP). 2015 Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Algorithms; Hemoptysiss Language Published English Country of organisation United States English summary An English language summary is available. Address for correspondence Center for Evidence-based Practice, University of Pennsylvania Health System, 3535 Market St. Suite 50, Philadelphia PA 19104 Email: Cep2

2015 Health Technology Assessment (HTA) Database.

13. Two cases of cryptogenic life‐threatening hemoptysis – identification and management of bleeding point (PubMed)

Two cases of cryptogenic life‐threatening hemoptysis – identification and management of bleeding point Case 1: A 63-year-old woman was referred for coughing blood. Although cardiorespiratory dynamics were stabilized by artificial respiration under sedation, severely poor ventilation developed from asphyxia associated with massive respiratory tract hemorrhage. One-lung ventilation was temporarily secured by endotracheal tube insertion into the left main bronchus just prior to cardiopulmonary (...) arrest.Case 2: A 72-year-old man was referred for massive hemoptysis after coughing, then intubated and placed on a respirator. During angiography, blood clots collected with bronchoscopy confirmed extravascular leakage into the right main bronchus.Both showed no hemoptysis recurrence after bronchial artery embolization and were discharged. Case 1 required intensive treatment for 6 days, including artificial respiratory management.Emergency one-lung ventilation was required for asphyxia in Case 1, and we

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2016 Acute medicine & surgery

14. Hemoptysis

Hemoptysis Date of origin: 1995 Last review date: 2014 ACR Appropriateness Criteria ® 1 Hemoptysis American College of Radiology ACR Appropriateness Criteria ® Clinical Condition: Hemoptysis Variant 1: Hemoptysis =30 cc OR 2 risk factors (>40 years old and >30 pack-year history). Radiologic Procedure Rating Comments RRL* X-ray chest 9 ? CTA chest with IV contrast 8 ??? CT chest without IV contrast 6 Consider this procedure if there is a contraindication to iodinated contrast. ??? Arteriography (...) bronchial with or without embolization 5 For patients with a preprocedure diagnosis that carries a high risk for recurrent hemorrhage. Varies Arteriography pulmonary 2 Consider this procedure for therapy. ???? Rating Scale: 1,2,3 = Usually not appropriate; 4,5,6 = May be appropriate; 7,8,9 = Usually appropriate *Relative Radiation Level Variant 2: Persistent/recurrent hemoptysis ( 40 years old, >30 pack-year history). Radiologic Procedure Rating Comments RRL* X-ray chest 9 ? CTA chest with IV contrast 8

2014 American College of Radiology

15. Single-phase Split-bolus Dual Energy Computed Tomography Angiography for Evaluation of Hemoptysis: A Novel Application. (PubMed)

Single-phase Split-bolus Dual Energy Computed Tomography Angiography for Evaluation of Hemoptysis: A Novel Application. The purpose of this study was to assess feasibility and overall utility of single-phase split-bolus dual energy computed tomography (DECT) angiography (DECTA) for evaluation of hemoptysis, and to establish an injection protocol for evaluation of hemoptysis, by comparing 2 contrast injection protocols.Using dual-source (80 and 140 kV), 2×128-slice equipment, DECTA was performed (...) using 400 mg iodine/mL, 50 to 80 mL iodinated contrast in 257 patients (189 male individuals, 68 female individuals, age range: 15 to 76 y) presenting with hemoptysis. Initially, 50 patients were randomized into 2 groups for 2 different injection protocols (A and B). Images were assessed quantitative and qualitatively. Later, 207 patients were randomized using protocol B, which was technically simpler, and single-CT acquisition, for simultaneous opacification of systemic and pulmonary

2018 Journal of thoracic imaging

16. Mediastinal teratoma presenting with hemoptysis and pleuritis misdiagnosed as tuberculosis (empyema). (PubMed)

Mediastinal teratoma presenting with hemoptysis and pleuritis misdiagnosed as tuberculosis (empyema). Mediastinal teratoma is uncommon in children. It can be very difficult to diagnose especially in early stage. Rarely, teratoma may rupture into adjacent structures and lead to lung lesions or pleuritis. The main rarity of our reported cases was the dynamic imaging findings very similar to the developmental process of tuberculosis in patients 1 and 2, the pachypleuritis in patients 2 and 3 (...) , the extremely elevated inflammatory markers very similar to empyema in patient 3, and the extremely atypical tumor shape in all patients.We present three pediatric patients presenting predominantly with recurrent hemoptysis and/or chest pain who were ultimately diagnosed with mediastinal teratoma containing pancreatic tissue. All three patients were initially suspected to have tuberculosis or empyema, and underwent relevant treatment, but without improvement. Patient 1 had left hilar enlargement

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2018 BMC Pediatrics

17. Pyogenic granuloma of the larynx: A rare cause of hemoptysis. (PubMed)

Pyogenic granuloma of the larynx: A rare cause of hemoptysis. Pyogenic granuloma (PG) may involve gingival mucosa (granuloma gravidarum) in pregnancy but rarely involves the airway. This case report is perhaps the only reported presentation of PG in the larynx causing hemoptysis at a late stage of pregnancy. On laryngoscopic exam, a vascular, right false vocal fold neoplasm was identified with pathological characteristics consistent with PG. Conclusions: Pyogenic granuloma is a relatively

2018 American Journal of Otolaryngology

18. Surgical approach to a mycotic aneurysm of the pulmonary artery presenting with hemoptysis – A case report and a review of the literature (PubMed)

Surgical approach to a mycotic aneurysm of the pulmonary artery presenting with hemoptysis – A case report and a review of the literature Mycotic aneurysms of the pulmonary arteries are very rare and have high mortality. Risk groups are intravenous drug users and patients with congenital heart disorders. The surgical approach varies due to a limited number of reported cases.We present a case of a mycotic aneurysm of the right pulmonary artery in a 56-year old man presenting with recurrent (...) pneumonias, weight loss and hemoptysis.There is often a diagnostic delay because of non-specific symptoms mimicking more common disorders. Treatment strategies include conservative management, surgery and endovascular treatment.This report demonstrates a rare case of aneurysm of the pulmonary artery presenting with hemoptysis. For rapidly progressing proximal aneurysms of the pulmonary arteries, the midline surgical approach is recommended.Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All

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2018 International journal of surgery case reports

19. A novel endobronchial approach to massive hemoptysis complicating silicone Y-stent placement for tracheobronchomalacia: A case report. (PubMed)

A novel endobronchial approach to massive hemoptysis complicating silicone Y-stent placement for tracheobronchomalacia: A case report. Airway stabilization for severe, symptomatic tracheobronchomalacia (TBM) may be accomplished by silicone Y-stent placement. Common complications of the Y-stent include mucus plugging and granulation tissue formation.We describe a rare case of massive hemoptysis originating from a silicone Y-stent placed for TBM.An emergent bronchoscopy showed an actively (...) polymer reinforced the tissue for complete cessation of the bleed.The combined use of ORC and a biocompatible surgical sealant provided long-term management for life-threatening hemoptysis, and potentially morbid procedures such as embolization or surgery were avoided by advanced endobronchial therapy.

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2018 Medicine

20. Transcatheter embolotherapy of pulmonary artery aneurysms as emergency treatment of hemoptysis in Behcet patients: experience of a referral center and a review of the literature. (PubMed)

Transcatheter embolotherapy of pulmonary artery aneurysms as emergency treatment of hemoptysis in Behcet patients: experience of a referral center and a review of the literature. Hemoptysis is a life-threatening complication of Behcet's disease that is likely related to pulmonary artery aneurysm (PAA). Vascular interventional radiology may offer effective emergency therapeutic option, but has not been thoroughly investigated in this setting. A case series of a French referral center (...) for hemoptysis combined with a literature review of case reports was conducted. Between 1995 and 2016, 12 patients were referred to our center for hemoptysis revealing or complicating the course of Behcet's disease. Pulmonary artery aneurysm (PAA) was the mechanism of hemoptysis in ten patients, nine of whom were treated by a transcatheter embolotherapy. Combining an additional 8 case reports from the literature, 17 patients treated by transcatheter embolotherapy for PAA were analyzed. The duration

2018 Internal and emergency medicine

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