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Two cases of cryptogenic life‐threatening hemoptysis – identification and management of bleeding point

机译:2例隐性威胁生命的咯血-出血点的识别和处理

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Cases Case 1: A 63‐year‐old woman was referred for coughing blood. Although cardiorespiratory dynamics were stabilized by artificial respiration under sedation, severely poor ventilation developed from asphyxia associated with massive respiratory tract hemorrhage. One‐lung ventilation was temporarily secured by endotracheal tube insertion into the left main bronchus just prior to cardiopulmonary arrest. Case 2: A 72‐year‐old man was referred for massive hemoptysis after coughing, then intubated and placed on a respirator. During angiography, blood clots collected with bronchoscopy confirmed extravascular leakage into the right main bronchus. Outcomes Both showed no hemoptysis recurrence after bronchial artery embolization and were discharged. Case 1 required intensive treatment for 6 days, including artificial respiratory management. Conclusion Emergency one‐lung ventilation was required for asphyxia in Case 1, and we had difficulties with bleeding point identification and hemostatic therapy. From that experience, we noted hemoptysis during angiography using bronchoscopy in Case 2, enabling prompt bronchial artery embolization.
机译:病例病例1:一名63岁的妇女因咳血而被转介。尽管镇静下的人工呼吸使心肺动力学稳定,但窒息导致的大量呼吸道出血导致严重的通气不畅。在心肺骤停之前,通过将气管插管插入左主支气管暂时确保单肺通气。案例2:一名72岁的男子因咳嗽被转为大咯血,然后插管并戴上呼吸器。在血管造影期间,通过支气管镜检查收集到的血凝块证实有血管外渗入右主支气管。结果支气管动脉栓塞后均无咯血复发,均已出院。病例1需要6天的强化治疗,包括人工呼吸处理。结论病例1窒息需要紧急单肺通气,在出血点识别和止血治疗方面存在困难。从这些经验中,我们注意到在案例2中,使用支气管镜进行血管造影时出现咯血,可以立即进行支气管动脉栓塞。

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