Pulmonary hemorrhage is dangerous complication arising in respiratory diseases, characterized by the expiry of the blood vessels (the lung or bronchi). With this pathological condition the patient requires emergency care.
When this pathology allocated blood due to impaired vascular integrity and result in disintegration of tissues. Profuse blood loss leads to a deterioration in the patient's state of health, there is a malfunction of the heart, respiratory system and hematopoiesis.
The most dangerous are bleeding occurring spontaneously: acute asphyxia becomes the cause of death.
Causes
A condition in which during coughing sputum noted the appearance of blood clots is called hemoptysis. It can go to the bleeding.
The main causes of pulmonary hemorrhage:
- bronchitis;
- pneumonia;
- bronchial asthma;
- pulmonary tuberculosis;
- bronchiectasis;
- lung abscess;
- chest trauma to lung injury;
- lung cancer;
- pulmonary fibrosis;
- gangrene;
- adenoma of the bronchus;
- pneumoconiosis;
- fungal and parasitic lesions (tsistozomatoz, echinococcosis, ascariasis et al.);
- pulmonary infarction;
- foreign bodies in the bronchi;
- diseases of the cardiovascular system (pulmonary embolism, Cardio, heart disease, hypertension, coronary heart disease).
Bleeding may occur with systemic pathologies:
- diathesis;
- vasculitis;
- the system of capillaries;
- rheumatism;
- Goodpasture's syndrome;
- gemosideroze lungs.
The development of a pathological condition contribute to the following factors:
- prolonged use of anticoagulant;
- nervous stress;
- ionizing radiation;
- allergies to medications drugs;
- effects on the body of hazardous substances;
- incomplete stop bleeding during the postoperative period (the initial stage);
- stagnation of blood in the veins of the pulmonary circulation;
- transplantation (organs, bone marrow).
The risk group includes people suffering from:
- pneumonia in the acute form;
- diabetes;
- Tuberculosis.
As well as:
- pregnant women;
- receiving glucocorticoids;
- migrants;
- elderly people;
- serving time in prison;
- people with low incomes.
Types and symptoms
Blood can be released through the sputum (coughing) or sinuses. It is bright red or dark, without additives or together with sputum (saliva).
Symptoms of pulmonary hemorrhage should become an occasion to call "fast" because the consequences can be severe.
Main symptoms of pulmonary hemorrhage - a slight hemoptysis and paroxysmal cough.
Classification of this disease includes three degree (taking into account the volume of blood loss):
- small (less than 100 ml for days);
- medium (50 ml of blood per day);
- large (greater than 500 ml per 24 hours).
With intensive blood loss occurs asphyxia threat that can cause death. The most dangerous are pathologies which occur spontaneously.
Bleeding happens:
- outdoor;
- mixed;
- inner (hereinafter leads to the development of a pneumothorax).
LK often appears suddenly, with little coughing. Redness of sputum showed a small tissue damage. The most common pathology is accompanied by:
- shortness of breath;
- hemoptysis;
- paroxysmal cough;
- palpitations;
- great weakness;
- fever;
- visual impairment;
- palpitations shallow breathing;
- pale skin;
- by pain in the chest;
- reduction in blood pressure;
- dizziness;
- tinnitus;
- convulsions;
- cyanosis of the skin.
Diagnostics
For diagnosis using:
- Medical history, physical examination, tapping and listening.
- Analysis of blood (total coagulogram +).
- Lung Research (radiography, ultrasound).
- CT or MRI.
- Bronchial arteriography.
- Angiopulmonography lungs.
- Echocardiography.
- Bronchoscopy.
- Sputum.
- Serological tests.
- PCR.
Doctor assigns research methods to the patient's complaints and symptoms of factors that may be present.
Sometimes you need to perform differential diagnosis of gastrointestinal bleeding.
Treatment
For the treatment of disease using:
- conservative therapy;
- minimally invasive;
- surgery.
First aid for pulmonary hemorrhage - giving the patient the position in which the blood would be better to withdraw.
The algorithm is:
- applying of bladder with ice to the chest;
- ingestion of cold water (sip) or pieces of ice.
In a hospital patient is placed on the affected side, necessary medications administered. Make bronchoscopy, surgical treatment is used if necessary.
First aid
Emergency treatment of pulmonary bleeding consists in relieving airway blood via aspirator styptic administration, blood transfusion
First aid should be provided as quickly as possible. If you suspect a pathology has arisen an urgent need to try to bring the patient to a hospital, where they can make the necessary arrangements and to stop the bleeding.
First medical aid includes a number of measures:
- cause "fast";
- reassure the patient;
- to give a sitting position or semi-sitting with legs lowered down;
- undo constraining clothes;
- provide fresh air;
- applying cold compress to affected side (for 15 minutes followed by a break);
- You can be given to swallow a few pieces of ice.
Emergency care in pulmonary hemorrhage, if it is minor, is the application of conservative treatment. It is strictly forbidden to use procedures of warming (banks, mustard, hot tub).
Further Medical assistance should be provided in pulmonology or surgical department.
Conservative treatment
Conservative treatment of pulmonary bleeding is to eliminate the disease causing the complication. Medications prescribed only in case of low or moderate bleeding form.
The following tools are used most often:
- Hemostatic (Gordoks sodium Etamsylate, Contrycal, Vikasol);
- hypotensive (clonidine, Pentamin, arfonad);
- analgetics (Analgin);
- antitussives (codeine formulations Promedol, dionin);
- transfusion of blood or blood products (in case of high blood loss);
- to prevent infection joining - antibiotics.
endoscopic
In the absence of the treatment result conservative methods operate to stop bleeding bronchoscopy. use:
- hemostatic sponge;
- applications with medical drugs;
- vascular coagulation in the lesion;
- obturation of the bronchi seals;
- embolization of bleeding vessels.
Such methods provide only temporary relief.
Surgery
If there was such a complication like bleeding from the lungs, surgical treatment is used. operations are:
- emergency (when continuing blood loss);
- urgent (immediately after stopping hemorrhage);
- delayed (after stopping blood loss as possible of the complete patient examination and preparation for surgery);
- plan (after stopping blood loss, Survey and preparation of the operation, performed in the most convenient time).
There are 2 types of operations:
- palliative (thoracoplasty, pulmonary artery ligation, collapse therapy, pneumonopathy, filling of Extrapleural);
- radical (partial removal of the lung, segmentectomy, bilobektomiya, wedge resection, lobectomy, pneumonectomy).
Considered inappropriate expectant management, t. To. It can lead to relapse, development of the inflammatory process in the lungs due to aspiration of blood and further progression of primary disease.
