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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A four-year experience with transtracheal aspiration was reviewed in order to determine those patients at risk for developing life-threatening complications. One hundred procedures were performed by at least 20 different physicians trained according to an established protocol. Complications were limited to minimal subcutaneous emphysema in 19 percent (10/52), pneumomediastinum in 3 percent (3/93), and gross but self-limited hemoptysis in 1 percent (one patient); occasional unifocal premature ventricular contractions were noted in one patient. We conclude that patients not at risk of developing life-threatening complications from transtracheal aspiration can be identified. They (1) are able to cooperate and have a clearly identifiable and normal cricothyroid membrane, (2) have the procedure performed only by well-trained or supervised physicians, (3) have an arterial oxygen pressure of at least 70 mm Hg with administration of supplemental oxygen, and (4) have a prothrombin activity of at least 65 percent of the control value or a normal bleeding time or a platelet count of at least 100,000/cu mm. To minimize subcutaneous emphysema or pneumomediastinum, no patient should have therapy with intermittent positive-pressure breathing or any other procedure that might induce coughing for the subsequent 24 hours.
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PMID:Transtracheal aspiration. Guidelines for safety. 49 22

Symptoms, clinical findings and pulmonary function in 47 patients with tracheobronchomalacia were compared with the bronchoscopic finding. The main symptoms were phlegm, cough, and dyspnoea. Recurrent respiratory infections and haemoptysis were features of the recent medical history. Only 30% had emphysema, and cor pulmonale in the ECG was uncommon. A notch in FEV1 was seen in 25 patients (54%), against 3 (6%) in the controls. FVC, FEV1/FIV1 and notch in FEV1 were directly proportionate to the severity of the malacia. A low FEV1/FIV1 and notch in FEV1 are suggestive of tracheobronchomalacia and an indication for bronchoscopy.
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PMID:Acquired tracheobronchomalacia. A clinical study with bronchological correlations. 61 23

The pulmonary complications of a 50-metre fall to the water (a form of suicide attempt producing 87% mortality) were studied in 15 survivors. Presenting findings included crackles, haemoptysis, and hypotension. The alveolar-arterial oxygen difference was greater than 150 mmHg (20 kPa) in nine subjects on admission. Ventilatory failure developed in 10 of the patients, including all of those with massive haemoptysis. Radiographic findings included pneumothorax and diffuse pulmonary opacities adjacent to the area of impact. Pneumothorax developed within 12 hours of admission in 10 of 15 subjects but was associated with rib fractures in only four subjects. The clinical course of the condition is consistent with the hypothesis that the traumatic pulmonary tears produced interstitial emphysema, with subsequent development of pneumomediastinum, subcutaneous emphysema, and pneumothorax. Pneumothorax is a common complication of severe lung contusion even in the absence of penetrating pleural injury.
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PMID:Lung injury following a 50-metre fall into water. 66 76

Major fracture of the intrathoracic airway following closed chest trauma is a potentially lethal injury which can be repaired successfully if the diagnosis is made early, Cough, dyspnea cyanosis, hemoptysis, mediastinal emphysema, or pneumothorax not responding to drainage via intercostal tube and a deterioration of the patient's clinical condition out of proportion to the apparent closed chest injury, should alert the clinician to the possiblity of this entity. This report describes the findings in a patient with a longitudinal disruption of the entire intrathoracic trachea and the findings in a second patient with complete transection of the right main bronchus. Each was repaired primarily, with eventual recovery, The principles of management of this difficult group of injuries are reviewed.
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PMID:Major airway injury in closed chest trauma. 87 56

In 23 patients with laryngotracheal trauma at the Louisville General Hospital during a ten-year period, 19 survived. One death was directly atributable to the airway injury. The most common postinjury complication was hoarsensess attributable to direct injury to the cords or recurrent nerve paralysis. One patient had further operation for subglottic stenosis. In general, blunt injuries were more severe than penetrating injuries. Subcutaneous emphysema, aphonia or dyshonia, hemoptysis, signs of injuries, a sucking wound, are presumptive findings of laryngotracheal injury. Appropriate endoscopy and radiographic studies should confirm the diagnosis. Control of the airway is achieved by emergency tracheostomy or intubation followed by tracheostomy. Prompt operative intervention and primary repair follow.
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PMID:Laryngotracheal trauma: recognition and management. 101 62

Two patients with closed rupture of the cervical trachea secondary to blunt trauma, one secondary to neck injury and the other secondary to thoracic injury, were analysed with those reported else where (58). Signs and symptoms included subcutaneous emphysema, respiratory distress, hoarseness/dysphonia, dysphagia, hemoptysis and so on. We conclude that: (1) the diagnosis of blunt trauma of the cervical trachea requires a high index of suspicion, since this injury can easily be overlooked; (2) tracheostomy is the best means of airway control; (3) good long-term airway quality is best obtained by immediate repair of injuries.
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PMID:[Closed rupture of the cervical trachea]. 130 96

Life threatening mediastinitis as a complication of acute epiglottitis is very rare. A 38-year-old male in previously good health was admitted to our hospital in a state of unconsciousness. Seven days prior to admission he had complained of a sore throat, dysphagia, high fever and dyspnea. A chest X-ray on admission showed widening of the mediastinum, mediastinal emphysema, subcutaneous emphysema and left pleural effusion. Bronchoscopy showed the swelling of supraglottic structures. He was diagnosed as having acute mediastinitis and pyothorax as a complication of acute epiglottitis, but pathogens were not identified. The blood was hyperglycemic and insulin therapy was started. Though he gradually improved by massive antibiotic therapy, steroid therapy, tracheotomy and surgical drainage of both the left thoracic cavity and the mediastinum, he died suddenly of massive hemoptysis. Autopsy revealed that the acute mediastinitis had healed, but that the Aspergillus infection was present in both lungs and the pericardium. The Aspergillus infection was not lethal in the present case, and it seemed that death had resulted from arterial hemorrhage caused by erosion of the trachea. The present case suggests the need for antifungal therapy even in non-immunocompromised patients in particular when massive doses of antibiotics and steroids are administered.
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PMID:[A case of mediastinitis and bilateral pyothorax, following acute epiglottitis with concurrent Aspergillus infection]. 140

The aim of this work is to determine the clinical characteristics of haemoptysis and their principal aetiologies in a retrospective study of 291 cases collected over 5 years and occurring in adults who were hospitalised in a pneumology service. The annual incidence of haemoptysis was 8.8% of the in-patient population. The mean age of the patients was 46 and 47% were less than 50. The males were most frequent (69.4%) and haemoptysis was the presenting feature in 35.4%; it was minimal in 71.1% of average quantity in 26.8% and severe in 2.1%. The thoracic radiograph was judged abnormal in all cases and the abnormalities noted were suggestive of a particular aetiology in 70.8% of cases. The aetiological cause was dominated by bronchial cancer and of active pulmonary tuberculosis or its sequalae with levels of 34.4% and 18.9% respectively. For the other causes bronchial dilatation was important with 15.1% and hydatic cysts another 9.3%. Other aetiologies were represented by bacterial pneumonias with or without abscesses 7.2%, pulmonary aspergilloma 6.9%, chronic bronchitis with or without emphysema 3.5% and by rare causes in 4 cases. The cause for the haemoptysis was not found in 3.1%. This study brings out the preponderant place of bronchial cancer as a cause of haemoptysis in a country which still has a high prevalence of tuberculosis. Nevertheless the existence of tuberculosis services where the greater part of tuberculosis patients are hospitalised explains in part the predominance of bronchial cancer increasing very rapidly in our service.
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PMID:[Clinical characteristics and etiology in hemoptysis in a pneumology service. 291 cases]. 161 2

Oxygen therapy through a transtracheal catheter has been used increasingly for the long-term delivery of continuous oxygen. Compared to nasal cannula it results in significant reduction in oxygen flow requirements. This form of therapy has gained patient acceptance because of several advantages including improved convenience, aesthetics, compliance, and mobility. Reported complications generally have been minor, including subcutaneous emphysema, cough, "mucous ball" formation and mild hemoptysis. In this report, we describe a case of granulation tissue formation at the transtracheal catheter puncture site which was treated with Nd:YAG laser bronchoscopy to reestablish patency of the upper airway. No recurrence was noted after two years of follow-up.
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PMID:Laser resection of granulation tissue secondary to transtracheal oxygen catheter. 172 84

A 68-year-old woman had pulmonary aspergilloma in the right upper lobe with old cavitary pulmonary tuberculosis. Despite intravenous fluconazole there was no change in the size of the fungus ball. Endobronchial instillation of fluconazole also failed. Subsequently percutaneous instillation of fluconazole was attempted with localized drainage. The fungus ball decreased in size after 8 weeks. Although slight hemoptysis and subcutaneous emphysema occurred in this case, these condition required no treatment. This method of treatment appears to be useful for inoperable cases of pulmonary aspergilloma.
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PMID:[Percutaneous instillation of fluconazole in the treatment of pulmonary aspergilloma]. 175 7


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