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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40 schema:keywords ConclusionsBacterial LRTI
41 PurposeSevere hemoptysis
42 SH
43 abundant bleeding
44 analysis
45 artery vasculature
46 bacterial lower respiratory tract infections
47 bacterial pulmonary infections
48 bleeding
49 care unit
50 cases
51 cause
52 center
53 clinical features
54 consecutive patients
55 decision-making process
56 efficacy
57 endovascular procedures
58 endovascular treatment
59 endovascular treatment failure
60 failure
61 failure rate
62 features
63 frequent need
64 hemoptysis
65 infection
66 intensive care unit
67 involvement
68 lower respiratory tract infections
69 mechanism
70 microbiological spectrum
71 multiple procedures
72 necrosis
73 need
74 nodules
75 non-necrotizing infections
76 non-tuberculosis bacterial lower respiratory tract infection
77 outcomes
78 parenchymal necrosis
79 patients
80 patterns
81 period
82 pneumonia
83 presence
84 procedure
85 process
86 prospective registry
87 pulmonary artery vasculature
88 pulmonary infection
89 pulmonary vasculature involvement
90 radiological patterns
91 rare cause
92 rate
93 referral center
94 registry
95 respiratory tract infections
96 results
97 severe hemoptysis
98 severity
99 severity of hemoptysis
100 significance
101 single-center analysis
102 spectra
103 strategies
104 study
105 study period
106 tertiary referral center
107 therapeutic strategies
108 tract infections
109 treatment
110 treatment failure
111 units
112 usual decision-making process
113 usual therapeutic strategies
114 vasculature
115 vasculature involvement
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