Definition and pathophysiology

  • Expectoration of blood or blood-streaked sputum
  • Massive hemoptysis: >100 mL/h or >500 mL in 24 h; massive hemoptysis usually from tortuous or invaded bronchial arteries
Etiologies (Crit Care Med 2000;28:1642)
Infection/ Inflammation Bronchitis (most common cause of trivial hemoptysis)
Bronchiectasis incl CF (common cause of massive hemoptysis)
TB or aspergilloma (can be massive); pneumonia or lung abscess
Neoplasm Usually primary lung cancer, sometimes metastasis (can be massive)
Cardiovasc PE (can be massive), pulmonary artery rupture (2° to instrumentation), CHF, mitral stenosis, trauma/foreign body, bronchovascular fistula