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Hemoptysis Updated 12/2010

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BASICS

  • Description
  • Etiology

DIAGNOSIS

  • Signs and Symptoms
  • Essential Workup
  • Tests
  • Differential Diagnosis

TREATMENT

  • Pre-hospital
  • Initial Stabilization
  • ED Treatment
  • Medication (Drugs)
  • In-patient Considerations

Ongoing Care

  • Follow-Up Recommendations
The following is an excerpt....
BASICS
Description
  • Expectoration of blood, originating from the tracheobronchial tree
  • Source of bleeding is typically from bronchial arteries (95%) or pulmonary arteries (5%):
    • Lesions to the bronchial arteries usually produce profuse bleeding, whereas bleeding from the pulmonary arteries generates only small amounts.
  • Threshold of massive hemoptysis defined has been defined from 100 mL–1L/24 h:
    • >8 mL/kg/d in children
    • Most common definition is >399 mL/24 hr
  • Mortality:
    • Massive hemoptysis (>500 mL/24 hr): 38%
    • Trivial to moderate hemoptysis (<500 mL/24): 4.5%
    • Malignancy and coagulopathy increase the risk of mortality.
Etiology
  • Infectious (most common cause):
    • Acute or chronic bronchitis
    • Pneumonia
    • Tuberculosis
    • Viral (influenza, varicella)
    • Fungal (Aspergillus, Coccidioides, Histoplasma, Blastomyces)
    • Parasitic (Ascariasis, Amebiasis, Paragonimiasis, Echinococcus)
  • Neoplastic:
    • Squamous cell, small cell, carcinoid ...

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