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Efficacy of Bronchial Occlusion With Pulmonary Artery Catheter for the Control of Haemoptysis FREE TO VIEW

Dante Alcala, MD; Rogelio Perez-Padilla, MD; Dante Escobedo, MD; Robledo Julio, MD; Claudia I. Olvera, MD
Author and Funding Information

Instituto Nacional de Enfermedades Respiratorias, Mexico DF, Mexico


Chest. 2003;124(4_MeetingAbstracts):131S. doi:10.1378/chest.124.4_MeetingAbstracts.131S
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PURPOSE:  Determine the efficacy of bronchial occlusion with pulmonary artery catheter (BOPAC) for the control of haemoptysis, and the factors associated with outcome.

METHODS:  All patients with haemoptysis managed with BOPAC admitted from October 1999 - December 2002 were categorised as massive and non-massive haemoptysis (cut-off point: 200ml). Data was gathered prospectively and logistic regression analysis was performed.

RESULTS:  We included 48 patients: 35 (73%) male, 13 (27%) female, mean age 50 ± 17 (13–75) years, 37 (77%) with massive haemoptysis and 11 (23%) non-massive. Main cause was bronchiectasis (45% n-22) and the most frequent comorbidity condition diabetes. Chest x-ray showed abnormalities in the upper lobes in 87% (n-42) and bronchoscopy showed active bleeding in 100%. In the first 48 hours, 30 patients (63%) rebled and of them, 20 (67%) bled although the catheter was in a correct position, 9 (30%) presented rupture of the PAC and one (3%) had a misplaced PAC, remaining 37% of the complete group with complete success. Second bronchoscopy was done in 33 patients with 13 PAC replacements with absolute control of the haemorrhage in 46%. Active bleeding showed to be statistically significant with p<0.037 and OR 4.16 CI 95(1.134–15.289) in presence of comorbidity for rebleding. Mortality was 17% (n-8), 6 (12.5%) of them with massive haemoptysis and 2 (4.1%) nonmassive, 100% of the rebled group (association of p=0.018).CONCLUSIONS: The failure incidence within the first 48 hours was 63%. Active haemorrhage with bronchoscopy that needs BOPAC increases 4 times the risk of rebleeding as well as identifies risk of death.

CLINICAL IMPLICATIONS:  BOPAC has high rebleeding risk and low efficacy for haemoptysis treatment. With a second attempt, efficacy diminishes so if active bleeding is found in bronchoscopy other techniques should be used.

DISCLOSURE:  D. Alcala, None.

Wednesday, October 29, 2003

10:30 AM - 12:00 PM




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