Massive Hemoptysis

  • Frank Genese
  • Norman Adair
  • David L. Bowton
  • Andrew M. NamenEmail author


Massive hemoptysis occurs in up to 10% of patients hospitalized for hemoptysis, and is associated with significant morbidity and mortality. Risk factors have been recognized to aid in identification of patients at highest risk of mortality. The initial volume of bleeding, respiratory compromise and hemodynamic status should dictate the diagnostic and treatment approach. An ABC (Airway, Blood loss, and Clinical features) mnemonic can assist with rapid assessment of the unstable patient. Based on the initial survey, one considers decisions of airway protection; isolating the affected lung; ICU transfer; radiographic and bronchoscopic evaluation; and interventional radiographic, bronchoscopic and/or surgical treatment. We present an illustrative case of massive hemoptysis and a suggested approach to care.


Hemoptysis Bronchoscopy Computed tomography Embolization Artificial airway ICU Interventional radiology 



American College of Radiology


Anti diuretic hormone


Argon plasma coagulation


Bronchial artery embolization


Descending thoracic aorta




Intensive care unit


Interventional radiology


Left lower lobe


Multidetector computed tomography


Right lower lobe


Right upper lobe


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Frank Genese
    • 1
  • Norman Adair
    • 1
  • David L. Bowton
    • 2
  • Andrew M. Namen
    • 1
    Email author
  1. 1.Department of Internal Medicine Division of Pulmonary, Critical Care and Allergy and ImmunologyWake Forest University School of MedicineWinston-SalemUSA
  2. 2.Department of AnesthesiologyWake Forest University School of MedicineWinston-SalemUSA

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