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Article: Multidisciplinary Management of Life-Threatening Massive Hemoptysis: A 10-Year Experience

TitleMultidisciplinary Management of Life-Threatening Massive Hemoptysis: A 10-Year Experience
Authors
Issue Date2009
Citation
Annals of Thoracic Surgery, 2009, v. 87 n. 3, p. 849-853 How to Cite?
AbstractBackground: Life-threatening massive hemoptysis requires prompt action and thoracic surgical input. Although there are a number of reports regarding each therapeutic modality for medical or surgical treatment, the significance of a multidisciplinary strategy remains undetermined. Methods: From January 1995 to December 2005, 120 patients were referred to our cardiothoracic center with massive hemoptysis. We retrospectively reviewed and compared the outcomes of a recent 5-year period (2000 to 2005) with those from the previous 5 years (1995 to 1999), as we made major changes in our practice in 2000. We currently try to avoid surgery within 48 hours after onset of active hemoptysis and adopt bronchial artery embolization as a first-line therapy. Treatment decisions are made after discussions among intensive care unit physicians, thoracic surgeons, and interventional radiologists. Results: The former group had 49 patients (57.9 ± 14.1 years old, 41 males), and the recent group, 71 (62.2 ± 23.5 years old, 52 males). There were no significant differences for any characteristics studied between the groups. In analyses of short-term complications after surgery, the former had a higher in-hospital mortality rate than the recent group (15% versus 0%). Furthermore, postoperative complications were seen in 8 patients (30%) in the former, whereas those occurred in 3 patients (18%) in the recent group. Conclusion: Bronchial artery embolization is an effective therapeutic tool and plays a pivotal role in management of life-threatening massive hemoptysis. Surgery is indicated when bronchial artery embolization is not suitable and can be safely performed in combination with a rigid bronchoscopy or bronchial artery embolization procedure. Our results indicate that a multidisciplinary approach should be adopted for management of life-threatening massive hemoptysis. © 2009 The Society of Thoracic Surgeons.
Persistent Identifierhttp://hdl.handle.net/10722/192669
ISSN
2015 Impact Factor: 2.975
2015 SCImago Journal Rankings: 1.490
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorShigemura, Nen_US
dc.contributor.authorWan, IYen_US
dc.contributor.authorYu, SCHen_US
dc.contributor.authorWong, RHen_US
dc.contributor.authorHsin, MKYen_US
dc.contributor.authorThung, HKen_US
dc.contributor.authorLee, T-Wen_US
dc.contributor.authorWan, Sen_US
dc.contributor.authorUnderwood, MJen_US
dc.contributor.authorYim, APCen_US
dc.date.accessioned2013-11-20T04:55:05Z-
dc.date.available2013-11-20T04:55:05Z-
dc.date.issued2009en_US
dc.identifier.citationAnnals of Thoracic Surgery, 2009, v. 87 n. 3, p. 849-853en_US
dc.identifier.issn0003-4975en_US
dc.identifier.urihttp://hdl.handle.net/10722/192669-
dc.description.abstractBackground: Life-threatening massive hemoptysis requires prompt action and thoracic surgical input. Although there are a number of reports regarding each therapeutic modality for medical or surgical treatment, the significance of a multidisciplinary strategy remains undetermined. Methods: From January 1995 to December 2005, 120 patients were referred to our cardiothoracic center with massive hemoptysis. We retrospectively reviewed and compared the outcomes of a recent 5-year period (2000 to 2005) with those from the previous 5 years (1995 to 1999), as we made major changes in our practice in 2000. We currently try to avoid surgery within 48 hours after onset of active hemoptysis and adopt bronchial artery embolization as a first-line therapy. Treatment decisions are made after discussions among intensive care unit physicians, thoracic surgeons, and interventional radiologists. Results: The former group had 49 patients (57.9 ± 14.1 years old, 41 males), and the recent group, 71 (62.2 ± 23.5 years old, 52 males). There were no significant differences for any characteristics studied between the groups. In analyses of short-term complications after surgery, the former had a higher in-hospital mortality rate than the recent group (15% versus 0%). Furthermore, postoperative complications were seen in 8 patients (30%) in the former, whereas those occurred in 3 patients (18%) in the recent group. Conclusion: Bronchial artery embolization is an effective therapeutic tool and plays a pivotal role in management of life-threatening massive hemoptysis. Surgery is indicated when bronchial artery embolization is not suitable and can be safely performed in combination with a rigid bronchoscopy or bronchial artery embolization procedure. Our results indicate that a multidisciplinary approach should be adopted for management of life-threatening massive hemoptysis. © 2009 The Society of Thoracic Surgeons.en_US
dc.languageengen_US
dc.relation.ispartofAnnals of Thoracic Surgeryen_US
dc.titleMultidisciplinary Management of Life-Threatening Massive Hemoptysis: A 10-Year Experienceen_US
dc.typeArticleen_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.athoracsur.2008.11.010en_US
dc.identifier.pmid19231404-
dc.identifier.scopuseid_2-s2.0-60449116289en_US
dc.identifier.volume87en_US
dc.identifier.issue3en_US
dc.identifier.spage849en_US
dc.identifier.epage853en_US
dc.identifier.isiWOS:000263791200026-

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