دورية أكاديمية
Management of life-threatening hemoptysis in the ICU.
| العنوان: | Management of life-threatening hemoptysis in the ICU. |
|---|---|
| المؤلفون: | Charya AV; Division of Pulmonary and Critical Care Medicine, University of Maryland Medical Center, Baltimore, MD, USA., Holden VK; Division of Pulmonary and Critical Care Medicine, Section of Interventional Pulmonology, University of Maryland School of Medicine, Baltimore, MD, USA., Pickering EM; Division of Pulmonary and Critical Care Medicine, Section of Interventional Pulmonology, University of Maryland School of Medicine, Baltimore, MD, USA. |
| المصدر: | Journal of thoracic disease [J Thorac Dis] 2021 Aug; Vol. 13 (8), pp. 5139-5158. |
| نوع المنشور: | Journal Article; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: AME Publishing Company Country of Publication: China NLM ID: 101533916 Publication Model: Print Cited Medium: Print ISSN: 2072-1439 (Print) Linking ISSN: 20721439 NLM ISO Abbreviation: J Thorac Dis Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Publication: Hong Kong : AME Publishing Company Original Publication: Hong Kong : Pioneer Bioscience Pub. Co. |
| مستخلص: | Life-threatening hemoptysis is commonly encountered in the ICU and its management can be challenging even for experienced clinicians. Depending on the etiology and severity, one can tailor the treatment modality and therapeutic intervention(s). The grading of severity of hemoptysis varies greatly in the literature; however, unlike hemorrhage in other scenarios, small amounts of blood can significantly impair oxygenation and ventilation leading to cardiovascular collapse. Importantly, the initial evaluation and management should focus on airway and hemodynamic stabilization along with maintenance of oxygenation and ventilation. In this review, we discuss commonly encountered etiologies, vascular anatomy, diagnostic evaluation, and therapeutic interventions. We examine the evolving trends in etiologies of life-threating hemoptysis over the years. The role of flexible and rigid bronchoscopy as both a diagnostic and therapeutic modality is explored, as well as the use and indications of several bronchoscopic techniques, such as topical hemostatic agents, endobronchial tamponade, and tranexamic acid (TXA). In addition, we assess the use of multi-row detector computed tomography as the initial rapid diagnostic method of choice and its use in planning for definitive treatment. The efficacy and long-term results of bronchial artery embolization (BAE) are evaluated, as well as indications for surgical intervention. Furthermore, the importance of a multidisciplinary approach is emphasized. The necessary interplay between intensivists, consultative services, and radiologists is described in detail and an algorithmic management strategy incorporating the above is outlined. Given the complexity in management of life-threatening hemoptysis, this paper aims to summarize the available diagnostic and therapeutic methods and provide a standardized approach for the management of patients with this often difficult to treat condition. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at: http://dx.doi.org/10.21037/jtd-19-3991). The series “Interventional Pulmonology in the Intensive Care Unit Environment” was commissioned by the editorial office without any funding or sponsorship. The authors have no other conflicts of interest to declare. (2021 Journal of Thoracic Disease. All rights reserved.) |
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| فهرسة مساهمة: | Keywords: Hemoptysis; bronchoscopy; life-threatening hemoptysis; massive hemoptysis; multidisciplinary approach |
| تواريخ الأحداث: | Date Created: 20210916 Latest Revision: 20210917 |
| رمز التحديث: | 20221213 |
| مُعرف محوري في PubMed: | PMC8411133 |
| DOI: | 10.21037/jtd-19-3991 |
| PMID: | 34527355 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2072-1439 |
|---|---|
| DOI: | 10.21037/jtd-19-3991 |