H E M O P T Y S I SH E M O P T Y S I S

Dr. Bayu Sukresno, Sp. PD

• Includes both streaked sputum and coughing up of gross blood

• ETIOLOGY :– Tracheobronchial source : bronchogenic

carcinoma, bronchitis, bronchiectasis, etc.– Pulmonary parenchymal source :

pneumonia,tuberculosis, lung abscess, etc.– Pulmonary vascular source : pulmonary

embolism, elevated pulmonary venous pressure, etc.

– Others : nasopharyngeal bleeding, gastrointestinal bleeding, etc.

• Essential to determine that blood is coming from respiratory tract. Often frothy, may be preceded by desire to cough.

• Diagnostic evaluation includes :– Chest radiograph– Bronchoscopy– CT scan

Treatment Treatment

• Treat the underlying condition.• Mainstays are bed rest and cough

suppression with an opiate (codeine 15-30 mg, or hydrocodone 5 mg every 4-6 hours).

• Patients with massive hemoptysis (>600 mL/day) and patients with respiratory compromise due to aspiration of blood should monitored intesively with suction and intubation equipment close by so that selective intubation to isolate the bleeding lung can be accomplished.

• Localized peripheral bleeding sites may be tamponaded by bronchoscopic placement of balloon catheter in a lobar or segmental airway.

• Central bleeding sites may be managed with laser coagulation.

• Bronchial artery catherization and embolization.