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

The radiological imaging of the respiratory tract by bronchography has apparently lost in importance since the introduction of newer imaging methods. Indications for and results of bronchography, performed after bronchoscopy with a flexible bronchoscope under local anesthesia, were analysed in 115 patients. In 68 the bronchography had been performed because of suspected bronchiectasis, in the others because of hemoptysis, cough or infiltration of unclear etiology. In 43% of patients who had undergone bronchography bronchiectasis was indeed found, in 47% there were isolated or additional changes in the bronchial system. In 70% the examination had furthered the diagnosis. The described method of bronchography was not significantly more uncomfortable than flexible bronchoscopy alone. Combined bronchoscopy and bronchography is thus a valuable procedure in the diagnosis of pneumonological abnormalities.
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PMID:[Bronchography during flexible bronchoscopy. Indications and results in bronchiectasis]. 360 34

The clinical management of massive hemoptysis in patients with cystic fibrosis proceeds according to the following paradigm. The site of bleeding is identified by bronchoscopy, ideally under general anesthesia. Then selective bronchial arteriography is performed. If collaterals to the spinal cord are visualized, arterial embolization is abandoned and pulmonary resection is undertaken within the limits of pulmonary function.
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PMID:Massive hemoptysis in patients with cystic fibrosis: three case reports and a protocol for clinical management. 397 67

A retrospective analysis of direct laryngoscopies performed at our institution in 1978 was undertaken utilizing computer technology. The population which consisted of 54% males and 46% females had an average age of 50.4 years. The most common symptom was hoarseness (83.6%). The most frequent benign and malignant diagnoses were vocal cord polyp and squamous cell carcinoma, respectively. Males predominated in all disease entities except vocal cord polyps. Benign disease entities presented most frequently with one or two symptoms, while malignant pathology presented with a varied array and number of symptoms. The indications: "tumor" seen on indirect laryngoscopy, sore throat, dysphagia, otalgia, upper respiratory tract obstruction, hemoptysis, cough and leukoplakia were most frequently associated with malignancy. Voice abuse occupations were most commonly associated with vocal cord polyps and tobacco and alcohol use was most frequently associated with laryngeal cancer. Eighty-five percent of direct laryngoscopies were done under general anesthesia with two-thirds utilizing direct suspension microlaryngoscopy.
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PMID:Direct laryngoscopy: a retrospective analysis. 666 56

Percutaneous, nonsurgical interventions using angiographic catheter techniques and radiologic guidance were used in the management of seven cases of various lesions of the chest and lungs. Successful catheter therapy included the embolization of a large, acquired, postinflammatory vascular malformation causing massive hemoptysis and a cavernous hemangioma of the chest wall. Sixteen pulmonary arteriovenous fistulas (one patient), an iatrogenic internal mammary artery-to-innominate vein fistula, and a persistent, postbiopsy bronchopleural fistula were successfully closed. Percutaneous drainage of a pyogenic lung abscess and the nonoperative retrieval of an intravascular foreign body that had embolized to the left pulmonary artery were also successfully achieved. Performed under local anesthesia with minimal morbidity, stress, and risk, interventional catheter therapy is remarkably cost-effective. Primary chest physicians are encouraged to consider this mode of therapy whenever applicable.
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PMID:Percutaneous interventional catheter therapy for lesions of the chest and lungs. 703 84

Eight patients in whom new respiratory symptoms developed following pulmonary resection have been evaluated. The bronchial stumps in all of these patients had been closed with Tevdec suture material. The total number of pulmonary resections using Tevdec suture from January, 1971, to January, 1980, was 180, yielding an incidence of the complication of 4.4%. No patient had empyema or bronchopleural fistula. Symptoms included nonproductive cough (eight patients), hemoptysis (five patients), wheezing (two patients), and coughing up suture material (two patients). The underlying disease necessitating pulmonary resection was carcinoma in five patients, carcinoid adenoma in one patient, tuberculosis in one patient, and bronchiectasis in one patient. The median time interval between resection and development of respiratory symptoms was 18 months, with a range of 8 to 57 months. The chest roentgenograms showed no change from earlier postoperative films. Bronchoscopy under general anesthesia was performed in all eight patients. Granulation tissue around loosened Tevdec sutures was present in all patients so examined. No residual tumor or specific infection was identified. Immediate and sustained relief of symptoms was obtained in seven of eight patients by removal of the loosened sutures. One patient has had recurrence of minor hemoptysis 18 months following suture removal but has refused further endoscopy. Stainless steel staples have been used for bronchial stump closure in over 100 pulmonary resections since 1977 and no such complications have been seen.
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PMID:Bronchoscopic diagnosis and treatment of bronchial stump suture granulomas. 720 61

Percutaneous lung biopsies with a cutting needle (Vim Tru Cut) were obtained from 20 horses. The procedure was performed in standing horses under a local anesthesia without sedation. All lung tissue specimens were suitable for histologic examinations and contained both pulmonary parenchyma and large airways. The only complication was hemoptysis in 2 (10%) horses which required no therapy. All horses were subsequently killed, and no gross abnormalities were present at the biopsy site.
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PMID:Percutaneous lung biopsy in the horse. 731 44

The patient presented in this report is unique in that he survived two aortobronchial fistulas. With such fistulas, intermittent hemoptysis is always present; pain is an infrequent symptom. Plain roentgenograms of the chest are helpful in denoting the presence of an aneurysm and the affected portion of the tracheobronchial tree. Aortography rarely demonstrates the fistula. Bronchoscopy should be conducted only with care when the diagnosis is in doubt since disaster can attend disruption of the clot in the fistula. Successful repair usually requires maintenance of distal circulation, repair of the aorta either by closure or by graft replacement, and repair of the tracheobronchial tree either by resection or primary suture. Anesthesia management should include selective endobronchial intubation to control possible intraoperative hemorrhage. Interposition of healthy living tissue to protect the suture lines is encouraged to prevent recurrence.
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PMID:Successful diagnosis and management of fistulas between the aorta and the tracheobronchial tree. 738 49

Two patients are described in whom fulminant haemoptysis occurred during extracorporeal circulation. The use of high frequency jet ventilation resulted in a dramatic decrease of blood loss from the tracheal tube, avoiding the need for more aggressive management.
Anaesthesia 1995 Feb
PMID:High frequency jet ventilation for severe haemoptysis during extracorporeal circulation. 771 27

Malignant airway obstruction affects up to 80,000 patients annually, many of whom will present acutely to the emergency department (ED). This clinical entity should be sought in any patient presenting to the ED with increasing shortness of breath, recurrent chest infections, hemoptysis, and an inability to lie flat. Interventions suggested in malignant airway obstruction include: maintenance of spontaneous ventilation by avoiding respiratory depressing sedation, muscle relaxants or narcotics; changes in patient's position; avoidance of general anesthesia and positive pressure ventilation, if possible; placement of endotracheal tube beyond the level of obstruction; radiotherapy; corticosteroids; availability of helium-oxygen mixtures, cardiopulmonary bypass, or extracorporeal membrane oxygenation. If time allows, further diagnostic studies will be of assistance in assessing the best therapy before definitive intervention.
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PMID:Malignant airway obstruction: recognition and management. 947 65

Systemic air or gas embolism has been increasingly recognized as a complication of serious chest trauma and often presents with catastrophic circulatory and cerebral events. The classic findings are hemoptysis, sudden cardiac or cerebral dysfunction after initiation of PPV, air in retinal vessels, and air in arterial aspirations. The clinician must be wary of more subtle presentations. Several diagnostic tools (TEE, Doppler, CT) can detect intracardiac and cerebral air, but they may not be necessary to confirm the diagnosis of SAE. Cessation of SAE is essential for successful resuscitation. In those with unilateral lung injury, this can theoretically be achieved by isolating and ventilating the noninjured lung. Sole reliance on immediate thoracotomy for hilar clamping to stem the flow of gas emboli is a concept that needs to be challenged. Whether airway and ventilation interventions will eliminate, delay, or decrease the need for thoracotomy and improve the prognosis of SAE remains to be seen. There is little reported in the literature regarding such interventions. Airway management of a patient at risk for SAE should include a technique that can selectively ventilate each lung. Patients with bilateral sources of SAE may benefit from the avoidance of high airway pressures. Regional anesthesia should be considered when appropriate. HBOT is useful in managing cerebral air embolism and should be incorporated as soon as possible. Clinicians involved in trauma care must be familiar with SAE. By adopting a problem-based solution through innovative airway and ventilation management, anesthesiologists may significantly alter and improve the morbidity and mortality rate of SAE resulting from chest trauma.
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PMID:Systemic air embolism after lung trauma. 1059 47


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