Diffuse alveolar hemorrhage etiology, diagnosis, treatment:
{{c1::SAVAMIDA (SLE/Antiphospholipid/Vasculitis, Anticoagulation/Mitral stenosis, Infectious/Drug-induced/ARDS) -> dyspnea/hypoxemia and CXR (diffuse ground-glass opacities) -> bronchoscopy with BAL (confirmatory, progressively more bloody on serial lavage) -> underlying cause (rheumatologic/infectious/drug-induced), supportive oxygen/avoid anticoagulation}}
SAVAMIDA - SLE / Antiphospholipid / Vasculitis, Anticoagulation / Mitral stenosis / Infectious, Drug induced, ARDS
dyspnea = > hypoxemia
Bronchoscopy diagnosis (progressively more bloody on serial lavage)
txt underlying cause rheumatologic methotrexate / corticosteroids
supportive oxygen / avoid anticoagulation
Massive Hemoptysis Management
PIC CBT
Positioning, Intubation, Cardiovascular support (IVF / transfusion)
Coagulopathy, bronchoscopy w/ tamponade
Imaging after stabilization
What is the procedure of choice to identify the site and attempt early therapeutic intervention for massive hemoptysis (> 600 mL/day)?
{{c1::Bronchoscopy}}
- bronchoscopy localizes the bleeding site, suctions the blood to help establish an airway, and can stop bleeding with cautery; this maintains the ABCs
- patients who continue to bleed after bronchoscopy may need surgical thoracotomy
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