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Pneumonia/COPD/Hemoptysis

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Presentation on theme: "Pneumonia/COPD/Hemoptysis"— Presentation transcript:

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Principles and Practice of Hospital Medicine, 2e

Chapter 90:  Hemoptysis

Christopher Knudson; Sukit Chaiyachati; Alvaro Velasquez

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Anatomy of hemoptysis, etiology of suspected hemoptysis.

  • INITIAL APPROACH TO A PATIENT WITH SUSPECTED HEMOPTYSIS
  • BEDSIDE EVALUATION OF HEMOPTYSIS
  • DIAGNOSTIC EVALUATION OF HEMOPTYSIS
  • TREATMENT OF HEMOPTYSIS
  • SUGGESTED READINGS
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Hemoptysis is coughing or spitting up blood or blood mixed with phlegm as a result of bleeding in the lower respiratory tract. The lower respiratory tract is defined as any part of the respiratory system that is below the vocal cords or glottis. This includes the trachea, bronchi, and pulmonary parenchyma. This definition is important in that blood that is generated from other sources has a very different evaluation, triage and treatment.

Hemoptysis may range from large amounts of frank blood to light streaks of blood in the sputum, which suggests that hemoptysis has diverse etiologies and pathology. Bleeding from the lower respiratory tract occurs from one of two sources: either the high-pressure systemic arterial blood supply or the lower pressure pulmonary arteries and their branches.

The lower respiratory tract blood supply starts proximally with the inferior thyroid arteries supplying the upper trachea. Next, the bronchial arteries, originating from the aorta at the level of T3 to T8, travel along the tracheobronchial tree with small penetrating arteries feeding the lower trachea and bronchi. The bronchial arteries end by anastomosing with branches of the pulmonary arteries, together forming the capillary bed around the alveoli. The pulmonary arteries travel alongside the bronchial arteries on the tracheobronchial tree, but only perform oxygen exchange once at the alveoli.

The significance of these anatomical considerations is that massive hemoptysis (defined below) is more likely coming from the systemic arteries, and the volume of blood may help elucidate the origin of the bleeding. Ninety percent of cases of massive hemoptysis are from bronchial arteries. The remaining 5% of cases are from the pulmonary arteries and 5% from other arteries.

It is also important to realize that bronchial, but not pulmonary arteries proliferate in the setting of inflammation. They can enlarge, become tortuous, and create pathologic high-pressure anastomosis with nearby pulmonary arteries. These abnormal vessels are highly prone to bleeding, and explain (in part) the hemoptysis encountered with chronic inflammatory disease (eg, cystic fibrosis, bronchiectasis), and facilitate our understanding of recurrent bleeding in these disorders.

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1. Hemoptysis Ali Sepehr

2. Case 1 month old male who began to have post operative hemoptysis.

3. First step control and protect airway If mild If massive

13. The POPE Agitation, Respiratory distress Tachypnea, tachycardia, rales, ronchi Blood tinged secretions A-a gradient Minutes to hours after the inciting event

20. Type II

21. Postextubation laryngospasm Epiglottitis Croup Choking/foreign body Strangulation Hanging Endotracheal tube obstruction Laryngeal tumor Goiter Mononucleosis Postoperative vocal cord paralysis Migration of Foley catheter balloon used to tamponade epistaxis Near drowning Intraoperative direct suctioning of endotracheal tube adapter Type I

22. Type II Post-tonsillectomy/ adenoidectomy Post-removal of upper airway tumor Improvement of choanal stenosis Removal of hypertrophic redundant uvula

23. Treatment Oxygen Intubation with PEEP Diuretics

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IMAGES

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    hemoptysis powerpoint presentation download

  2. PPT

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  3. PPT

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  4. PPT

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  5. PPT

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VIDEO

  1. An Approach to Hemoptysis

  2. HEMOPTYSIS

  3. Hemoptysis: causes, diagnosis and management

  4. hemoptysis

  5. Hemoptysis || Causes and Management

  6. Hematopoiesis

COMMENTS

  1. HEMOPTYSIS PowerPoint Presentation, free download

    Jan 02, 2020. 460 likes | 559 Views. HEMOPTYSIS. Suhail Allaqaband Sinai Samaritan Medical Center Milwaukee, WI. HEMOPTYSIS. Hemoptysis, or the expectoration of blood, can range from blood-streaking of sputum to the presence of gross blood in the absence of any accompanying sputum. Download Presentation. pulmonary. pulmonary artery.

  2. PPTX PowerPoint Presentation

    Complementary to bronchoscopy. Helps identify bronchial artery anatomy. Limited utility in unstable patient (consider airway prior to scanning) GENERAL MANAGMENT. correct coagulopathy. · Reverse anticoagulants (FFP, Cryo, Vit K) · Treat platelet dysfunction (ddAVP) transfuse if necessary. · No exact cutoff defined in literature.

  3. Hemoptysis PowerPoint Presentation, free download

    Management • Massive hemoptysis-over 600ml blood/24 hours. • Considered life threatening and is a medical emergency. • Requires immediate treatment, surgery, or bronchoscopy. • Management should focus on managing cardiorespiratory parameters, correction of hypoxia, stabilization of blood pressure, and blood transfusions if necessary.

  4. HEMOPTYSIS PowerPoint Presentation, free download

    A 30 year-old woman with hemoptysis. Case Presentation. The patient is a 30 year-old Pakistani woman with CF who presents complaining of large-volume hemoptysis.The patient was relatively well until 1 month PTA when she developed an increasing productive cough.

  5. Hemoptysis

    Hemoptysis - Free download as Powerpoint Presentation (.ppt), PDF File (.pdf), Text File (.txt) or view presentation slides online. This document discusses the evaluation and management of hemoptysis (coughing up blood). It covers the differential diagnosis, important historical factors to consider, physical exam findings, initial workup including labs and imaging, and procedures used for ...

  6. HEMOPTYSIS

    HEMOPTYSIS - Free download as Powerpoint Presentation (.ppt), PDF File (.pdf), Text File (.txt) or view presentation slides online. Hemoptysis is defined as coughing up blood from the lungs or bronchial tubes. It can be classified as either massive or non-massive based on blood loss. Common causes include infections like tuberculosis, lung cancers, and bronchitis.

  7. HEMOPTYSIS

    HEMOPTYSIS - Free download as Powerpoint Presentation (.ppt), PDF File (.pdf), Text File (.txt) or view presentation slides online. Hemoptysis is defined as coughing up blood from the lungs or bronchial tubes. Mild hemoptysis involves less than 100 ml of blood per day, while massive hemoptysis involves more than 500 ml of blood per day or 150 ml per hour, with a mortality rate of 80% for ...

  8. HEMOPTYSIS by Prof. Arvind Mishra M.D. Department of medicine

    Presentation on theme: "HEMOPTYSIS by Prof. Arvind Mishra M.D. Department of medicine"— Presentation transcript: Acute life threatening condition. Blood can fill the airways and the alveolar spaces. Seriously disturbing gas exchange and may lead to asphyxia. 4 Establish Hemoptysis Should be differentiated from hemetemesis.

  9. Pneumonia/COPD/Hemoptysis

    Case 1 26-year-old male Vital signs: 38.6,102,20,126/78, E4V5M6 Fever for 2 days Productive cough for 3 days No dyspnea, no chest pain, no respiratory distress No past medical disease

  10. PPT

    2. HEMOPTYSIS. Hemoptysis, or the expectoration of blood, can. range from blood-streaking of sputum to the. presence of gross blood in the absence of any. accompanying sputum. The term massive hemoptysis is reserved for. bleeding that is potentially life-threatening.

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    Hemoptysis - Free download as Powerpoint Presentation (.ppt), PDF File (.pdf), Text File (.txt) or view presentation slides online. The document discusses hemoptysis, defined as coughing up blood originating from the subglottic airways. It can range from mild to massive in amount. The anatomy and pathophysiology of hemoptysis are described.

  12. Hemoptysis

    Hemoptysis is coughing or spitting up blood or blood mixed with phlegm as a result of bleeding in the lower respiratory tract. The lower respiratory tract is defined as any part of the respiratory system that is below the vocal cords or glottis. This includes the trachea, bronchi, and pulmonary parenchyma. This definition is important in that ...

  13. Massive Hemoptysis PowerPoint Presentation, free download

    Massive Hemoptysis. Mar 19, 2019. 700 likes | 1.53k Views. Massive Hemoptysis. D. P. Laporta MD Departments of Adult Critical Care and Medicine, Sir MB Davis Jewish General Hospital McGill University presented to McGill Residents Critical Care (January 2000) Pulmonary (July July 2000. MASSIVE HEMOPTYSIS REFERENCES. Download Presentation.

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    hemoptysis - Free download as Powerpoint Presentation (.ppt / .pptx), PDF File (.pdf), Text File (.txt) or view presentation slides online. Hemoptysis refers to the expectoration of blood from the respiratory tract. Massive hemoptysis is defined as expectoration of more than 100-600mL of blood over 24 hours and can be life-threatening by filling the airways and impairing gas exchange.

  16. Download Free Medical Hemostasis PowerPoint Presentation

    Description : Check out this medical PowerPoint presentation titled "Hemostasis". This medical PowerPoint presentation is about hemostasis,s the physiological process by which bleeding is stopped. It involves a series of steps that begin with the formation of a platelet plug to stop the bleeding from a damaged blood vessel, followed by the coagulation or clotting of blood to strengthen and ...

  17. Hemoptysis 1

    Hemoptysis 1.pptx - Free download as Powerpoint Presentation (.ppt / .pptx), PDF File (.pdf), Text File (.txt) or view presentation slides online. Hemoptysis refers to the expectoration of blood from the lower respiratory tract. It can range from mild to massive (over 600 mL of blood loss in 24 hours). The most common causes are bronchitis, lung cancer, tuberculosis, and bronchiectasis.

  18. Download Free Medical Hemostasis PowerPoint Presentation

    Free Download Hemostasis PowerPoint Presentation. Check out this medical PowerPoint presentation titled "HEMOSTASIS".<break><break>This medical PowerPoint presentation is about hemostasis, the process by which the body stops bleeding after an injury. It involves a series of steps that work together to form a clot and prevent excessive blood loss.

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  20. PPT

    Hemoptysis Ali Sepehr . 2. Case 1 month old male who began to have post operative hemoptysis. 3. First step control and protect airway If mild If massive . 4. DDx . 13. The POPE Agitation, Respiratory distress Tachypnea, tachycardia, rales, ronchi Blood tinged secretions A-a gradient Minutes to hours after the inciting event 20. Type II . 21.