Bei Hämoptysen handelt es sich um ein seltenes Krankheitsbild, das gleichwohl die
Kliniker*innen vor allem in der Behandlung ausgeprägter Hämoptysen vor eine massive
Herausforderung stellen
kann. Eine interdisziplinäre Betreuung liefert das bestmögliche Ergebnis für die Patient*innen.
Ziel dieser Arbeit ist es, das Management und die unterschiedlichen Behandlungsmöglichkeiten
der Hämoptysen darzustellen und praktische Empfehlungen für den Alltag zu geben.
Abstract
Hemotpysis is a rather rare clinical disease, though treatment (especially of massive
hemoptysis) might pose a challenge for clinicians. Hemoptysis is defined as expectoration
of blood
from the lower respiratory tract and is considered massive at more than 300 ml/24 h.
In 95% the source of bleeding are the bronchial arteries. The most common causes for
hemoptysis are
infectional pulmonary diseases, lung cancer or pulmonary embolism. Management priorities
are surveying vital signs, applying oxygen, positioning the patient on the affected
side and airway
protection. Therapy of hemoptysis often requires interdisciplinary skills of bronchologists,
anesthesiologists, radiologists and thoracical surgeons. For imaging a CT scan with
iv contrast
is the examination of choice, nontheless a bronchoscopy should always be performed
(irrespective of the dimension of hemotpysis). In most cases a conservative management
is not sufficient.
Bronchoscopy can accurately determine the site of bleeding, if the source of bleeding
is within the central airways bronchoscopy can supply a definitive therapy. In cases
of continuous
bleeding a radiological or surgical intervention might be required.
Schlüsselwörter
Hämoptysen - Bronchialarterienembolisation - Bronchoskopie - Hämoptysenmanagement
Keywords
hemoptysis - bronchial artery embolization - bronchoscopy - management of life-threatening
hemoptysis
