Pulmonary bleedings

Ewa Jassem; Jacek Jassem

Vol 2, No 1 (2003): Polish Palliative Medicine

Artykuły poglądowe

Published online: 2002-10-30

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Pulmonary bleedings

Ewa Jassem, Jacek Jassem

Advances in Palliative Medicine 2003;2(1):23-30.

Vol 2, No 1 (2003): Polish Palliative Medicine

Artykuły poglądowe

Published online: 2002-10-30

Abstract

Pulmonary bleedings typically accompany advanced chronic diseases of the respiratory system. Massive bleedings, apart form imminent threats, is associated with strong patient fear and considerably deteriorates quality of life. Immediate diagnosis and active therapy are therefore essential. Emergency measures include facilitating bronchial passage, sedation, intravenous injection of 10–40 ml of 10% NaCl solution, antitussive and antifibrinolitic agents, as well as epinephrine inhalations. Bronchoscopy should be attempted to establish the cause and localisation of bleeding, to allow blood aspiration and clot removal. In selected cases surgical intervention should be considered. Supportive therapy includes antihemostatic agents and compounds stimulating prothrombin synthesis. Effective palliative measure of recurrent pulmonary bleeding is vessel embolisation. Bleeding related to advanced lung cancer should primarily be managed with externalbeam irradiation or brachytherapy.