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Utility of high-resolution chest CT scan in the emergency management of haemoptysis in the intensive care unit: severity, localization and aetiology

¹ Departments of Radiology, ² Intensive Respiratory Care Unit, Tenon Hospital, AP-HP, Paris, France

View larger version (15K): [in this window] [in a new window]   Figure 1. Haemoptysis severity. Comparison of lobar involvement with blood loss. The number of lobes involved(3 to 6 lobes) was correlated with the daily volume of haemoptysis (p<0.04).

View larger version (23K): [in this window] [in a new window]   Figure 2. Haemoptysis management in the respiratory intensive care unit(RICU). Patients admitted to the RICU could be managed according to the presence of persistent active bleeding and the amount of bleeding during the previous 24 h. In case of persistent active bleeding, fibre-optic bronchoscopy (FOB) should be performed first to localize the bleeding site and to start a local treatment. In case of intermittent bleeding, a high-resolution computed tomography (HRCT) scan could be performed first to localize the site, assess severity and diagnose the cause of bleeding. In our institute, patients with bleeding of more than 200 ml per 24 h (independent of respiratory function) are guided to interventional radiology.