Severe Hemoptysis Associated with Bacterial Pulmonary Infection: Clinical Features, Significance of Parenchymal Necrosis, and Outcome View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-10-12

AUTHORS

Guillaume Carteaux, Damien Contou, Guillaume Voiriot, Antoine Khalil, Marie-France Carette, Martine Antoine, Antoine Parrot, Muriel Fartoukh

ABSTRACT

PurposeSevere hemoptysis (SH) associated with non-tuberculosis bacterial lower respiratory tract infection (LRTI) is poorly described, and the efficacy of the usual decision-making process is unknown. This study aimed at describing the clinical, radiological patterns, mechanism, and microbiological spectrum of SH related to bacterial LRTI, and assessing whether the severity of hemoptysis and the results of usual therapeutic strategy are influenced by the presence of parenchymal necrosis.MethodsA single-center analysis of patients with SH related to bacterial LRTI from a prospective registry of consecutive patients with SH admitted to the intensive care unit of a tertiary referral center between November 1996 and May 2013.ResultsOf 1504 patients with SH during the study period, 65 (4.3%) had SH related to bacterial LRTI, including non-necrotizing infections (n = 31), necrotizing pneumonia (n = 23), pulmonary abscess (n = 10), and excavated nodule (n = 1). The presence of parenchymal necrosis (n = 34, 52%) was associated with a more abundant bleeding (volume: 200 ml [70–300] vs. 80 ml [30–170]; p = 0.01) and a more frequent need for endovascular procedure (26/34; 76% vs. 9/31; 29%; p < 0.001). Additionally, in case of parenchymal necrosis, the pulmonary artery vasculature was involved in 16 patients (47%), and the failure rate of endovascular treatment was up to 25% despite multiple procedures.ConclusionsBacterial LRTI is a rare cause of SH. The presence of parenchymal necrosis is more likely associated with bleeding severity, pulmonary vasculature involvement, and endovascular treatment failure. More... »

PAGES

33-42

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00408-017-0064-8

DOI

http://dx.doi.org/10.1007/s00408-017-0064-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1092189215

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29026982


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33 schema:description PurposeSevere hemoptysis (SH) associated with non-tuberculosis bacterial lower respiratory tract infection (LRTI) is poorly described, and the efficacy of the usual decision-making process is unknown. This study aimed at describing the clinical, radiological patterns, mechanism, and microbiological spectrum of SH related to bacterial LRTI, and assessing whether the severity of hemoptysis and the results of usual therapeutic strategy are influenced by the presence of parenchymal necrosis.MethodsA single-center analysis of patients with SH related to bacterial LRTI from a prospective registry of consecutive patients with SH admitted to the intensive care unit of a tertiary referral center between November 1996 and May 2013.ResultsOf 1504 patients with SH during the study period, 65 (4.3%) had SH related to bacterial LRTI, including non-necrotizing infections (n = 31), necrotizing pneumonia (n = 23), pulmonary abscess (n = 10), and excavated nodule (n = 1). The presence of parenchymal necrosis (n = 34, 52%) was associated with a more abundant bleeding (volume: 200 ml [70–300] vs. 80 ml [30–170]; p = 0.01) and a more frequent need for endovascular procedure (26/34; 76% vs. 9/31; 29%; p < 0.001). Additionally, in case of parenchymal necrosis, the pulmonary artery vasculature was involved in 16 patients (47%), and the failure rate of endovascular treatment was up to 25% despite multiple procedures.ConclusionsBacterial LRTI is a rare cause of SH. The presence of parenchymal necrosis is more likely associated with bleeding severity, pulmonary vasculature involvement, and endovascular treatment failure.
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41 abundant bleeding
42 analysis
43 bacterial lower respiratory tract infections
44 bacterial pulmonary infections
45 bleeding
46 care unit
47 cases
48 cause
49 center
50 clinical features
51 consecutive patients
52 decision-making process
53 efficacy
54 endovascular procedures
55 endovascular treatment
56 endovascular treatment failure
57 failure
58 failure rate
59 features
60 frequent need
61 hemoptysis
62 infection
63 intensive care unit
64 involvement
65 lower respiratory tract infections
66 mechanism
67 microbiological spectrum
68 multiple procedures
69 necrosis
70 need
71 nodules
72 non-necrotizing infections
73 outcomes
74 parenchymal necrosis
75 patients
76 patterns
77 period
78 pneumonia
79 presence
80 procedure
81 process
82 prospective registry
83 pulmonary artery vasculature
84 pulmonary infection
85 radiological patterns
86 rare cause
87 rate
88 referral center
89 registry
90 respiratory tract infections
91 results
92 severe hemoptysis
93 severity
94 severity of hemoptysis
95 significance
96 single-center analysis
97 spectra
98 strategies
99 study
100 study period
101 tertiary referral center
102 therapeutic strategies
103 tract infections
104 treatment
105 treatment failure
106 units
107 usual decision-making process
108 usual therapeutic strategies
109 vasculature
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