[Life-threatening hemoptysis in cystic fibrosis: clinical characteristics and management in 36 episodes].
BACKGROUND
Our goal was to evaluate the clinical characteristics and management of life-threatening hemoptysis in patients with cystic fibrosis (CF).


METHODS
We included adult CF patients followed up at the Cystic Fibrosis Units of the Autonomous Community of Madrid who had life-threatening hemoptysis from June 1990 to December 1999.


RESULTS
Twelve CF patients (4 females) developed 36 episodes of life-threatening hemoptysis (30 massive and 6 recurrent). Lung disease was moderate to severe. Sputum cultures revealed Pseudomonas aeruginosa in 10 patients. Thirteen episodes (36%) resolved upon antibiotic treatment and 3 (8%) after antibiotic therapy and bronchoscopy. Bronchial artery embolization (BAE) was performed in 20 of 36 events. Immediate technique success was achieved in 80% episodes (16 of 20) after one session, 85% (17/20) after two sessions, and 95% (19/20) after three sessions. No major complications associated with the procedure were seen. The overall recurrence rate per episode was 69% (24 of 35 episodes in 6 patients) with a mean time of recurrence of 13 months. There were no massive hemoptysis-associated deaths during the follow-up.


CONCLUSIONS
Life-threatening hemoptysis is a frequent complication in CF patients who have moderate or severe lung disease. When conservative therapeutic measures (including antibiotics) fail to control it, BAE should be performed. When performed by expert professionals, BAE is effective and safe to immediate control of life-threatening hemoptysis in patients with CF.
Máiz
Luis
L
Servicio de Neumología, Unidad de Fibrosis Quística, Hospital Ramón y Cajal, Spain. lmaiz@hrc.insalud.es
Girón
Rosa
R
Martínez
María Teresa
MT
Prados
Concepción
C
Escobar
Héctor
H
Garzón
Gonzalo
G
Sánchez
Juan
J
Mingo
Alberto
A
Blázquez
Javier
J
D000293:Adolescent; D000328:Adult; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications*; D005260:Female; D006469:Hemoptysis / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D012189:Retrospective Studies