Journal Article

The efficacy and safety of combined therapy with endobronchial tamponade and bronchial artery embolization for massive hemoptysis

Lai, Huiting, Chen, Zhiyu, Lin, Chaohui, Liu, Dexin, Peng, Zhuli, Cai, Donglu, Chen, Yanfeng

2024

Overview

Background Massive hemoptysis is characterized by its life-threatening nature, potentially leading to airway obstruction and asphyxia. The objective of this study was to evaluate the clinical effectiveness of combining endobronchial tamponade with bronchial artery embolization (BAE) in the treatment of massive hemoptysis. Methods Between March 2018 and March 2022, a total of 67 patients with massive hemoptysis who underwent BAE were divided into two groups: the combination group ( n  = 26) and the BAE group ( n  = 41). Technical and clinical success rates were assessed, and adverse events were monitored following the treatment. Blood gas analysis and coagulation function indicators were collected before and after the treatment, and recurrence and survival rates were recorded during the follow-up period. Results All patients achieved technical success. There were no significant differences in the clinical success rate, recurrence rates at 3 and 6 months, and mortality rates at 3 months, 6 months, and 1 year between the combination group and the BAE group. However, the hemoptysis recurrence rate at 1 year was significantly lower in the combination group compared to the BAE group (15.4% vs. 39.0%, P  = 0.039). No serious adverse events were reported in either group. After treatment, the combination group showed higher levels of arterial partial pressure of oxygen (PaO2), oxygenation index (PaO2/FiO2), fibrinogen (FIB), and D-dimer (D-D) compared to the BAE group ( P  < 0.05). Multivariate regression analysis demonstrated a significant correlation between combined therapy and hemoptysis-free survival. Conclusion Combination therapy, compared to embolization alone, exhibits superior efficacy in improving respiratory function, correcting hypoxia, stopping bleeding, and preventing recurrence. It is considered an effective and safe treatment for massive hemoptysis.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Adverse events / Aged / Airway management / Asphyxia / Blood coagulation / Blood Gas Analysis / Blood pressure / Bronchial Arteries / Bronchial artery embolization / Bronchoscopy / Bronchoscopy - methods / Care and treatment / Catheters / Combination therapy / Combined Modality Therapy / Critical Care Medicine / Efficacy / Embolization / Embolization, Therapeutic - methods / Endobronchial tamponade / Evaluation / Female / Fibrinogen / Hemoptysis / Hemoptysis - etiology / Hemoptysis - therapy / Humans / Hypoxia / Intensive / Internal Medicine / Intervention / Intravenous catheterization / Local anesthesia / Male / Massive hemoptysis / Medical imaging / Medicine / Medicine & Public Health / Methods / Middle Aged / Mortality / Patient outcomes / Patients / Pneumology/Respiratory System / Recurrence / Respiratory function / Retrospective Studies / Success / Survival / Tamponade / Treatment Outcome / Veins & arteries