Management of patients who underwent bronchoscopy due to massive hemoptysis and the importance of bronchial artery embolization

BACKGROUND AND AIM: The aim of this study is to evaluate the etiology, length of stay, treatment modality and treatment success in patients who underwent bronchoscopy due to massive hemoptysis. METHODS: The study is a cross-sectional study and was carried out with 148 patients who were transferred to our center with the complaint of massive hemoptysis between January 1, 2018 and January 1, 2021. RESULTS: The average age of the study group is 55.64±17.54. 71.6% of the patients in the study group were male. Etiological causes of patients with massive hemoptysis who underwent bronchoscopy were determined as bronchiectasis, lung cancer, tuberculosis, arterio-venous malformation and aspergilloma, respectively. The patients underwent 64.9% bronchial artery embolization (BAE), 29.7% medical treatment and 5.4% surgical treatment. The average length of stay in the intensive care unit is 4.66 days, while the length of stay in the service is 3.51 days. Relapse was seen in 9.45% of patients after BAE. The mean time to recurrence was 137.28 days. It was determined that hemoptysis recurred under 90 days in 8 cases and over 90 days in 6 cases. The success rate of BAE treatment was 90.55% and no mortal complications were observed. CONCLUSIONS: Massive hemoptysis is a life-threatening and urgent condition. Maintaining airway patency and controlling bleeding is a priority. We think that the patient should be hospitalized and followed up in the intensive care unit, contrast-enhanced thorax computed tomography and bronchoscopy should be performed in the rapid diagnosis process, BAE should be preferred first in the treatment, and surgical and other treatments should be applied if necessary.