Source: Annual Congress 2004 - New developments in endobronchial treatment

Abstract

Introduction: Massive hemoptysis is a life threatening condition.Therapeutic strategies, such as interventional angiography, surgery and/or bronchoscopy have been applied in the clinical setting with variable results.We investigated the efficacy of bronchoscopy guided topical hemostatic therapy (THT) using oxidized regenerated cellulose mesh (ORC) in the management of life threating hemoptysis.
Methods:32 consecutive patients underwent emergency bronchoscopy for massive hemoptysis (>200ml expectorated blood/hour) due to various causes. 26 patients (81%) had persistent endobronchial bleeding despite bronchoscopic wedging technique, cold saline lavage and instillation of regional vasoconstrictors. Subsequently they underwent THT during the same procedure.
Results: THT with ORC was successfully performed in all with an immediate arrest of hemoptysis for the whole study population. All patients remained free of hemoptysis for the first 48 hours and none required intensive care support or immediate surgery. 4 patients (15%) had mild (<30ml) to moderate (30-100ml) recurrence of hemoptysis 3 to 6 days after THT. There were few procedure related complications. 3 subjects (11%) developed post-obstructive pneumonia after endoscopic THT. 10 patients underwent bronchoscopic follow up 4 weeks after discharge. The ORC mesh was absorbed in all of these patients without visible foreign body reaction.
Conclusions: Endobronchial THT using ORC is a safe and practicable technique in the management of life threatening hemoptysis with a high success and a low complication rate.

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A. Valipour, A. Kreuzer, H. Koller, W. Koessler, D. Kiss, O. C. Burghuber (Vienna, Austria). Bronchoscopy guided topical hemostatic therapy for the management of life threatening hemoptysis. Eur Respir J 2004; 24: Suppl. 48, 4291

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