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Vol 11, No 4 (2017)
Review paper
Published online: 2018-02-28
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Hemoptysis — causes, diagnosis and treatment

Katarzyna Jusyk, Alicja Siemińska, Ewa Jassem
Medycyna Paliatywna w Praktyce 2017;11(4):166-173.

open access

Vol 11, No 4 (2017)
Review articles
Published online: 2018-02-28

Abstract

Hemoptysis is defined as the expectoration of blood originated from lung parenchyma or airways. Among the most frequent causes of hemoptysis are lung neoplasms, bronchiectases and respiratory tract infec­tions. In patients with low risk of lung cancer chest x-rays and bronchoscopy are considered the mandatory diagnostic examinations. If no abnormalities are found further, chest computed tomography is not required. In turn, patients with high risk of lung cancer should undergo wide diagnostics, keeping in mind that some minimal neoplastic changes can be invisible in chest x-rays and bronchoscopic examinations. The kind of treatment methods to undertake and the potential need for their urgency depend on the patient’s general condition and the intensity of bleeding. In case of massive hemoptysis, constant monitoring of patient’s vital signs is required, as well as the immediate airway patency control with rigid bronchoscopy or endobronchial intubation. Pharmacological treatment includes tranexamic acid, etamsylate, hypertonic saline 10% intravenous bolus. If this treatment appears ineffective and/or hemoptysis recurs endobronchial treatment and/or bronchial artery embolization is recommended. In terminally ill lung cancer patients aggressive treatment is usually given up in case of massive hemoptysis.

Abstract

Hemoptysis is defined as the expectoration of blood originated from lung parenchyma or airways. Among the most frequent causes of hemoptysis are lung neoplasms, bronchiectases and respiratory tract infec­tions. In patients with low risk of lung cancer chest x-rays and bronchoscopy are considered the mandatory diagnostic examinations. If no abnormalities are found further, chest computed tomography is not required. In turn, patients with high risk of lung cancer should undergo wide diagnostics, keeping in mind that some minimal neoplastic changes can be invisible in chest x-rays and bronchoscopic examinations. The kind of treatment methods to undertake and the potential need for their urgency depend on the patient’s general condition and the intensity of bleeding. In case of massive hemoptysis, constant monitoring of patient’s vital signs is required, as well as the immediate airway patency control with rigid bronchoscopy or endobronchial intubation. Pharmacological treatment includes tranexamic acid, etamsylate, hypertonic saline 10% intravenous bolus. If this treatment appears ineffective and/or hemoptysis recurs endobronchial treatment and/or bronchial artery embolization is recommended. In terminally ill lung cancer patients aggressive treatment is usually given up in case of massive hemoptysis.

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Keywords

hemoptysis, lung neoplasms, bronchoscopy, chest X-ray, pharmacological treatment

About this article
Title

Hemoptysis — causes, diagnosis and treatment

Journal

Palliative Medicine in Practice

Issue

Vol 11, No 4 (2017)

Article type

Review paper

Pages

166-173

Published online

2018-02-28

Bibliographic record

Medycyna Paliatywna w Praktyce 2017;11(4):166-173.

Keywords

hemoptysis
lung neoplasms
bronchoscopy
chest X-ray
pharmacological treatment

Authors

Katarzyna Jusyk
Alicja Siemińska
Ewa Jassem

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