Management of acute pulmonary hemorrhage in children.

OBJECTIVE

Acute pulmonary hemorrhage can result from a variety of causes. This report offers a diagnosis and treatment plan for children with acute, life-threatening pulmonary hemorrhage resulting from a variety of causes.

METHODS

Retrospective review of children with acute pulmonary hemorrhage cared for at a tertiary care children's hospital during from January 1, 1993 to September 1, 1999.

PATIENTS: Fourteen children were identified with life-threatening pulmonary hemorrhage during the study period.

INTERVENTIONS: Bronchoscopy was the keystone to diagnosis of pulmonary hemorrhage in this series. All of the children underwent multiple procedures to stabilize the airway and control blood loss. These interventions included CO2 laser bronchoscopy, Nd-YAG laser bronchoscopy, endoscopic balloon occlusion of a lobe or main bronchus, topical airway vasoconstrictors, endoscopic tumor excision, transcatheter embolization of bronchial vessels, and lobectomy.

OUTCOMES: Three children died and 11 survived without neurological sequelae.

CONCLUSIONS

Control of acute pulmonary hemorrhage is a difficult problem and often requires multiple procedures. Endoscopic control is usually required for palliation until more definitive therapy can be undertaken.