"Other roughly synonymous monikers (i.e. equivalent to massive) include "severe," "life-threatening," or "major" haemoptysis. Regardless of terminology, the majority of classification systems largely attempt to dichotomize patients into those with a high degree of mortality requiring rapid intervention and those with a lower degree of acuity and expected short term morbidity and mortality."
"Other roughly synonymous monikers (i.e. equivalent to massive) include "severe," "life-threatening," or "major" haemoptysis. Regardless of terminology, the majority of classification systems largely attempt to dichotomize patients into those with a high degree of mortality requiring rapid intervention and those with a lower degree of acuity and expected short term morbidity and mortality."
"Infection and acute or chronic inflammation of the lower respiratory tract accounts for the majority of cases of haemoptysis; the most common entities include acute and chronic bronchitis, pneumonia, and pulmonary tuberculosis (TB). Malignancy is implicated in a significant percentage of cases, with primary lung cancer cited as the aetiology in between 5 to 44% of patients 13."
"Roughly 5–14% of patients will meet the variable criteria for "massive" or "life-threatening" haemoptysis, with a somewhat different epidemiology; the most common aetiologies include bronchiectasis, TB, invasive fungal infections (e.g. mycetoma), necrotising infections, and neoplasms 14. In highly endemic areas tuberculosis may account for up to 85% of cases 15."
"Massive haemoptysis is a term commonly used in the aforementioned, with definitions based upon criteria such as volume of blood expectorated per cough and/or rate of production, with some proposed systems additionally utilising physiologic modifiers, such as 15:"
Expected headings
"Approach to haemoptysis"
"Approach to massive haemoptysis"
"Infection and acute or chronic inflammation of the lower respiratory tract accounts for the majority of cases of haemoptysis; the most common entities include acute and chronic bronchitis, pneumonia, and pulmonary tuberculosis (TB). Malignancy is implicated in a significant percentage of cases, with primary lung cancer cited as the aetiology in between 5 to 44% of patients 13."
"Roughly 5–14% of patients will meet the variable criteria for "massive" or "life-threatening" haemoptysis, with a somewhat different epidemiology; the most common aetiologies include bronchiectasis, TB, invasive fungal infections (e.g. mycetoma), necrotising infections, and neoplasms 14. In highly endemic areas tuberculosis may account for up to 85% of cases 15."
"In 90% of cases the bronchial arteries are the source of bleeding; as branches of the descending thoracic aorta they are subject to the systemic (i.e. high-pressure arterial) blood pressure 12. Other less common potential sources of bleeding include:"
"This approach can be followed for small amounts of blood or streaks of blood in sputum. The underlying cause can be life-threatening; however, it is not an emergency."
"collateral vessels derived from a variety of adjacent mediastinal/thoracic vasculature 11 (e.g. subclavian artery, intercostal arteries, internal thoracic artery)"
"development may be promoted by a chronic inflammatory milieu in the respiratory tract (e.g. elaboration of VEGF)"
"transtracheal interventions (e.g. diagnostic aspiration, anaesthesia)"
"airway protection, optimisation of oxygenation and ventilation, circulatory support with consideration of pharmacologic haemostatic adjuncts (e.g. coagulopathy reversal)"
"Optimal management involves a team of multiple specialties with important facets of the initial approach to stabilisation, diagnosis and management including the following:"