Abstract
Massive hemoptysis is a frightening and life-threatening event in children. Prompt, aggressive evaluation and management are necessary. The most common cause of hemoptysis in a pediatric patient is infectious, but other various etiologies including tracheotomy related problems, cystic fibrosis, bronchiectasis, congenital anomalies of the cardiopulmonary vasculature and suction trauma must be considered as well. Presented is a report of a case of acute, massive endotracheal hemorrhage with multiple methods of management including balloon tamponade, highly selective embolization, and mainstem occlusion. This case is an addition to our previously reported case series of nine pediatric patients with massive pulmonary hemorrhage. Various diagnostic and management techniques of hemoptyis in pediatric patients are discussed with an extensive review of the literature.
Highlights
Hemoptysis, a relatively common event in the adult population, is a rare occurrence in the pediatric setting
The threat of asphyxia from airway obstruction is greater than the threat of dying from exsanguination
In all patients suffering from massive pulmonary hemorrhage, initial priorities are to maintain the airway, optimize oxygenation, and obtain hemodynamic stability
Summary
Hemoptysis, a relatively common event in the adult population, is a rare occurrence in the pediatric setting. The most common cause of hemoptysis in the pediatric patients is infectious, but a multitude of etiologies must be considered [1]. The threat of asphyxia from airway obstruction is greater than the threat of dying from exsanguination. Successful airway management is paramount to prevent immediate respiratory failure, and to the swift determination of the location of bleeding through clear visualization and unobstructed instrumentation. A case of massive hemoptysis is discussed along with new techniques for its management. This case is an addition to the previously published nine case experiences of large pulmonary hemorrhage in the pediatric population
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