Abstract
Massive hemoptysis is occurring with increasing frequency in older patients with cystic fibrosis; it signifies a poor prognosis. Twenty-nine episodes occurring in 19 patients are analyzed. Thirteen of the 19 patients died within 6 months of the initial episode. No single aspect of the pulmonary treatment program has been incriminated. Half of the episodes were associated with a significant exacerbation of pulmonary symptomatology. Active bronchiectasis with blood vessel invasion was felt to be the pathologic process in all cases. Treatment consisted of transfusions and supportive care. Surgical resection was performed on one patient. In view of the poor response to medical therapy, a more aggressive surgical approach might be justified in selected patients.
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