Massive hemoptysis in a respiratory ICU: causes, interventions and outcomes - Indian study
© Talwar et al.; licensee BioMed Central Ltd. 2012
Published: 20 March 2012
Massive hemoptysis carries high mortality and morbidity, requiring multidisciplinary management. In India, tuberculosis is a very common cause of severe hemoptysis and is being treated in tuberculosis hospitals where such an approach is not available. We evaluated the profile of patients admitted with massive hemoptysis in a well-equipped Indian tertiary-care respiratory center.
Retrospective analysis of 376 patients admitted with hemoptysis to the respiratory ICU of the Metro Center for Respiratory Diseases, India was done. We identified 90 patients with massive hemoptysis (>600 ml in 24 hours) between 2005 and 2011 and the results were analyzed. As per our protocol all patients had active medical management and those suitable for surgery underwent elective or emergent surgery. Unsuitable candidates underwent bronchial artery embolisation (BAE) or bronchoscopic interventions (BI) and if suitable were taken for surgery later.
Types of management versus mortality in massive hemoptysis
All-cause mortality in massive hemoptysis at our center was 18.8%. Lung cancer, necrotizing pneumonia and bronchiectasis carried significantly higher mortality. BAE showed low mortality but required multiple interventions in nearly two-thirds of cases. Hence, surgery remains the intervention of choice in massive hemoptysis at our setup with acceptable mortality and outcome.
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