Diagnosis of pulmonary hemorrhage. Pulmonary hemorrhage

Pulmonary hemorrhage is an emergency condition characterized by the release of blood from the lower respiratory tract when coughing. This is a serious, often fatal complication of many pulmonary diseases. If its signs are detected, an ambulance must be immediately called medical care regardless of the cause of the condition. In another outcome, asphyxia occurs - lack of air due to the closure of the air cavities in the lungs with blood.

Reasons

The most common causes of pulmonary hemorrhage are acute and chronic diseases lungs:

In addition, the discharge of blood from the lungs can accompany a number of diagnostic and therapeutic procedures:

Biopsy lung tissue, bronchus.
Puncture of the pleural cavity.
Installation of pleural drainage.
The period after lung surgery.
Bronchoscopy.

About 40% of bleeding from the lungs is associated with tuberculosis process, 30% - from bacterial infection. If the cause is tissue breakdown during lung cancer, the incidence is about 15-20%.

Speaking about vessels damaged during the development of bleeding from the lungs, there are two main sources:

Bronchial arteries included in the systemic circulation.
Branches pulmonary artery, representing part of the pulmonary circulation.

It is worse if the bleeding occurs from the pulmonary artery system, the branches of which have a larger diameter than the bronchial vessels. Consequently, bleeding is more intense and less responsive conservative methods hemostasis (medicines).

Damage to the bronchial branches often accompanies chronic pulmonary pathology (pneumoconiosis, tuberculosis, neoplasms, bronchiectasis, etc.), and the blood has a bright scarlet color. Pulmonary vascular defects are more common with pulmonary embolism, pneumonia, and the oozing blood is darker, because belongs to the venous bed. Lung injury involves vascular damage of both types.

Classification

By external manifestations There are two types of this emergency condition: hemoptysis and direct pulmonary hemorrhage. The first is characterized by visually distinguishable streaks of blood in total mass coughing up sputum or occasional blood spitting. The second is characterized by copious, constantly coughing up volumes of blood.

From a practical point of view, the most useful classification is based on the amount of blood received, reflecting the severity of the patient’s condition:

Severity of pulmonary hemorrhage		Volume of lost blood, ml
I	A	50 per day
	B	50-200 per day
	IN	200-500 per day
II	A	30-200 per hour
II	B	200-500 per hour
III	A	100 immediately (simultaneously)
III	B	over 100 and/or complete blockage of the respiratory tract with the development of asphyxia

Starting from II B degree, blood loss with pulmonary hemorrhage are regarded as life threatening patient and require more active actions upon his stop.

Symptoms

Typically, patients notice the appearance of blood itself or its admixture in the sputum when coughing. Signs of pulmonary hemorrhage include the discharge of bright scarlet foamy blood without clots. It foams due to mixing with air bubbles in the respiratory tract. If only hemoptysis is present, the blood appears as small streaks against a normal background. In some cases, hemoptysis is a harbinger of the development of full-blown bleeding from lung tissue.

Given the variety of causes of this condition, the patient may experience other symptoms of pulmonary hemorrhage. They rather characterize the severity of the causative disease and can be expressed to varying degrees:

Increased body temperature.
Chest pain that gets worse with deep breathing.
Feeling short of air.
Dyspnea.
Unmotivated weight loss over a short period of time.
Periodic discharge of purulent sputum.
Tendency to bleeding from other locations.
Aches in muscles, joints.

If lost large quantity blood, symptoms of “centralization of blood circulation” appear. Those. The body tries to increase blood flow in conditions of decreased circulating blood volume. These include increased heart rate, breathing, pallor skin, sticky sweat, feeling of goosebumps crawling on the surface of the body, spots before the eyes.

Diagnostics

When the condition is stable (no change in pressure level, breathing is smooth, pulse is symmetrical, normal frequency) the victim should collect the sputum secreted by him in a container to estimate the approximate volume of blood in it. Conduct medical examination, including:

Analysis of patient complaints, paying attention to the duration and changes in symptoms over time.
Auscultation of the lungs (moist rales may be heard, especially in the lower regions).
Measuring body temperature.

At the stage of providing medical care in a hospital setting, the following diagnostic techniques are performed:

general analysis blood;
biochemical blood test;
coagulogram;
electrocardiography;
echocardiography;
microscopy of collected sputum;
sputum culture;
determination of blood group and Rh factor;
radiography chest;

The most informative is spiral computed tomography (SCT), which allows in 80% of cases to determine the source of bleeding. For life-threatening types of pulmonary hemorrhage, all diagnostic procedures are performed in intensive care units.

Differential diagnosis

First of all, it is necessary to assess the presence of signs of gastric bleeding due to the close location of the organs of these systems. Unlike pulmonary bleeding, with gastric bleeding the blood is not scarlet in color and does not foam; among the symptoms there is vomiting “coffee grounds” (dark brown or almost black vomit containing blood, chemically oxidized gastric juice). Bleeding from the vessels of the esophagus is also not characterized by a foamy appearance of blood, but it is usually lighter than with gastric bleeding.

It is important not to confuse blood from the lungs with blood from oral cavity, pharynx and nose, pouring out in small portions from their damaged mucous membrane. There is no foam, but the scarlet color remains.

First aid

First aid for pulmonary hemorrhage should always begin with calling an ambulance. In this case, you need to introduce yourself, briefly and informatively describe the situation, and do not forget to give the address. Do not allow the patient to tilt their head back. Best position patient with bleeding - sitting with the body and head tilted forward or lying on the affected side with the head turned to the side. Subsequently, during transportation, the person is placed in the Fowler position - lying on his back, lifting head part by 15 degrees. This is done to prevent blood and/or sputum from being thrown into the healthy lung, as well as for the convenience of coughing them up.

K to medical care include freeing the victim from restrictive clothing (belts, collars, scarves, etc.). Open the windows, thus ensuring an influx fresh air into the room. Constantly stay close to the patient, monitoring the level blood pressure and breathing rate. Make sure that the patient does not make sudden movements; it is better that he remains as motionless as possible and does not speak.

By the way first aid in case of pulmonary hemorrhage, all the people around the patient who were nearby at the time of the manifestation of clinical signs are involved.

Medical assistance

Patients with bleeding of I-II A degrees of severity are hospitalized in urgently to the thoracic surgery department, while victims with degree II A are placed in the ward intensive care. Life-threatening bleeding is treated in intensive care units.

The algorithm of actions for pulmonary hemorrhage begins with the installation venous catheter into one of the veins upper limbs(usually ulnar) and oxygen therapy with nasal catheters. To reduce coughing attacks, antitussive tablets are given:

Codeine 0.005-0.02 g.
Ethylmorphine hydrochloride (Dionine) 0.01 g.
Hydrocodeone phosphate 0.005 g.

To stop bleeding, intravenous administration of tranexamic acid (Tranexam) is necessary, 10 ml (2 ampoules) x 2-3 times a day. If your blood pressure is high, it can be lowered using intravenous drugs, expanding the lumen of venous vessels:

Nitroglycerin 0.1% at 0.16-0.25 mcg per 1 kg of body weight per minute.
Sodium nitroprusside 0.25-10 mcg per 1 kg of body weight per minute.

In case of significant loss of intravascular blood volume, it is replenished with 0.9% sodium chloride solution and 5% glucose solution.

If within emergency care In case of pulmonary hemorrhage, it was possible to determine its exact source; it is necessary to carry out one of endoscopic methods hemostasis:

Therapeutic and diagnostic fibrobronchoscopy in combination with introduction into bronchial tree hemostatic solutions, adrenaline, temporary blockage of the bronchial lumen with a special balloon.
Intravascular embolization (closure) of an artery.

The use of drugs and endoscopic hemostasis for pulmonary hemorrhage is a temporary measure. Usually only bleeding mild degree severity can be stopped using these methods. The rest is planned surgery depending on the patient's underlying disease. If possible, it is carried out within the first 48 hours from the onset of symptoms:

Lung resection.
Ligation of the bronchus and blood vessels at different levels.
Removal of tuberculous cavities, etc.

Where to go

If symptoms similar to pulmonary hemorrhage appear, it is necessary to call an emergency medical team, which includes a paramedic or doctor, nurse, orderly Only if there are small streaks in the sputum can you independently get to the office of the local general practitioner or paramedic, as well as to the emergency department (if there is one at the local hospital).

Pulmonary hemorrhage is a serious condition requiring urgent measures according to him as much as possible quick elimination. When the first signs of this pathology appear, you should not hesitate to call a doctor. Otherwise, there is a risk of both anemia and significant blood loss with the development of shock and a drop in blood pressure.

Sometimes pulmonary hemorrhage is preceded by pain or unpleasant warmth in the chest, severe cough with sputum of a salty taste. However, it can also start suddenly. In this case, blood is coughed up with sputum or in pure form. It is usually bright red, foamy and does not coagulate. However, if the blood has been in the lungs for a long time, it may be dark and clotted. Blood from the lungs can also come through the nose.

This condition may be accompanied by decreased blood pressure, pallor, and even loss of consciousness. Bubbling rales are usually heard in the lungs.

It is important to distinguish pulmonary hemorrhage from hemoptysis. Unlike pulmonary hemorrhage, with hemoptysis, streaks of blood appear in the sputum or saliva. Most often, this blood is already coagulated.

Description

The source of bleeding may be in the lungs, bronchi, or trachea below vocal cords. It occurs when the integrity of arteries, veins or capillaries is violated, as well as when lung tissue collapses. This can occur with inflammatory processes in the lungs, pulmonary tuberculosis, lung cancer, aneurysms, abscesses, pulmonary endometriosis, foreign bodies in the lungs or bronchi, helminthic infestations, pneumonia, pneumosclerosis, influenza, hypertension, mitral heart disease. Pulmonary hemorrhage may be a consequence of lung surgery or a lung biopsy.

At risk are:

those suffering from pulmonary diseases;
people with low socioeconomic status;
those suffering from diabetes;
long-term users of glucocorticoid drugs;
pregnant women and women who have recently given birth;
prisoners;
migrants.

Based on the amount of blood, pulmonary hemorrhages are divided into:

small (less than 100 ml);
moderate (from 100 to 500 ml);
profuse (more than 500 ml).

First aid

First, you need to lay the person with pulmonary hemorrhage on his back, slightly lifting him top part body, and provide free breathing. After this you need to call an ambulance. A person suffering from pulmonary hemorrhage should not drink or eat.

Diagnostics

To diagnose this disease, you need to consult a pulmonologist. A chest x-ray and tracheobronchoscopy will be required. In some cases, these studies are not enough; you need to additionally do bronchial arteriography and computed tomography.

It is important not only to establish which vessel is damaged, but also why this happened. And for this you need to take a general and biochemical blood test, a general urine test. It is necessary to carry out bacteriological analysis sputum. Additional consultation with an infectious disease specialist, angiologist or oncologist may be required.

However, in most cases, all these studies are carried out after the pulmonary hemorrhage has stopped.

Treatment

Pulmonary hemorrhage is treated in a hospital. The patient must be in a semi-sitting position at all times and is advised to go to bed.

Previously, in order to stop the bleeding, they swallowed ice. Now you don’t have to do this, since there are many much more effective ways.

For treatment, drugs that promote blood clotting are prescribed; blood transfusions and various hemostatic agents are also indicated, calcium chloride, glucose.

The bleeding vessel, if possible, is pressed with a tampon containing adrenaline or epsilon-aminocaproic acid.

It is important not only to stop the bleeding, but also to eliminate the cause of its occurrence. If the cause is infection, antibacterial and anthelmintic drugs are used. If the cause is a tumor, aneurysm or foreign body- it is removed.

Pulmonary hemorrhage is the release of blood by the pulmonary or bronchial vessels with its subsequent removal through the respiratory tract. This condition may be provoked various diseases respiratory organs. It poses a danger not only to health, but also to human life, and therefore requires assistance. Emergency care for pulmonary hemorrhage should be provided as soon as possible, only in this case the prognosis for the patient can be favorable.

Symptoms

To identify pulmonary hemorrhage, you should know its signs. The main symptoms of this pathological condition look like this:

Hemoptysis is observed. At this time, when coughing, no significant amount sputum streaked with blood.
Next, blood clots that have a deep scarlet color may be coughed up.
If the discharge of blood from the lungs is strong, then blood may additionally flow from the nasal passages. In this case, it looks like scarlet foam; clots do not come out through the nose.
At first, a person suffers from dryness, paroxysmal cough, then the cough becomes productive and blood clots are released.
There is a sore feeling in the throat. If the discharge is abundant, a slight gurgling sound may occur.
The patient feels a characteristic burning sensation on the affected side of the sternum.
The pressure drops, the skin becomes pale.
The heartbeat quickens, the patient's skin is covered with cold, sticky sweat.
If the bleeding is heavy, there may be tinnitus, cramps and vomiting. Vision is often impaired.

If pulmonary bleeding continues for a couple of days, the patient develops aspiration pneumonia. In some cases, asphyxia occurs.

It is necessary to distinguish between the concepts of hemoptysis and pulmonary hemorrhage. In the first case, only small streaks of blood are present in the sputum, but in the second, a significant amount of blood is released. It can flow either through the mouth or through the nose.

Reasons

Bleeding from the lungs may occur due to various reasons. These may be diseases incorrect treatment or incorrect implementation of some medical manipulations. Until about 50 years ago, bleeding from the lungs was observed mainly in patients with tuberculosis, gangrene or oncological pathologies. The source of bleeding in this case was the vessels of the pulmonary circulation.

Now the situation has changed radically. Pulmonary hemorrhages due to blood vessels are increasingly being diagnosed great circle blood circulation This phenomenon is observed when chronic bronchitis and advanced pneumonia. Patients with tuberculosis encounter this pathology as a complication of infiltrative forms of the disease.

A foreign body stuck in the bronchus or in the tissues of the lungs can also lead to bleeding.

In case of pulmonary hemorrhage, the patient should be provided with complete rest. If a person is very nervous, it is necessary to calm him down and cheer him up, because nervous condition increases blood flow.

Urgent Care

In case of pulmonary hemorrhage, it is very important to provide first aid in a timely and correct manner. Due to this, you can hold out the time necessary until the doctor arrives. You should be guided by the following algorithm of actions:

The patient must be seated correctly. Correct position In case of pulmonary hemorrhage, the injured person should be sitting, with the torso slightly tilted forward, as well as the head. This will prevent the patient from choking on blood. It is strictly forbidden to tilt the patient's head back, as this can lead to choking.
If it is not possible to sit a person down, then he is placed in bed on the side on which the lung is damaged. This position somewhat compresses the lung and reduces blood loss; in addition, blood from the damaged organ does not flow to the healthy side.
An ice pack or cloth soaked in water is placed on the chest area. cold water. If there is no ice in the house, then you can use frozen fruits or vegetables from the freezer. Due to the cold, a spasm occurs small vessels and blood loss is reduced. The cold is applied for 15 minutes, after which a break of a couple of minutes is taken and the procedure is repeated.
The victim must be provided with complete rest. He should not talk or be nervous.

It is strictly forbidden to give water to a person with pulmonary hemorrhage. If he is thirsty, you can moisten your lips with a piece of bandage dipped in cold water with the addition of a few drops of lemon juice.

First aid can be provided not only by a health worker, but also by one of your relatives. It is advisable to use medications only after examining the patient by a doctor. Only in exceptional cases, when the doctor cannot arrive quickly, is it allowed to administer Vikasol to the patient intramuscularly. This medicine Helps quickly stop pulmonary bleeding. As emergency assistance can be used and medicinal product Dition, but this medicine must be administered intravenously, after preliminary dilution with saline.

If convulsions are observed, the patient is prescribed Seduxen or Diazepam. To eliminate pain Promedol is recommended.

Previously, Morphine was used to relieve pain during pulmonary hemorrhages, but now this drug is used extremely rarely.

Pulmonary hemorrhage in infants

Pulmonary hemorrhage in newborns may be associated with complications of childbirth, prolonged asphyxia, extreme prematurity, congenital pathologies heart and blood vessels, as well as pulmonary edema. Modern medicine allows you to quickly provide assistance to a newborn baby and remove him from a dangerous state.

To prevent bleeding from the lungs, doctors perform a series of preventive measures, which are as follows:

Conducted resuscitation measures with replenishment of plasma proteins.
Pulmonary edema is relieved with Furosemide.
Prevention of increased blood clotting.
Conducted replacement therapy surfactant to normalize the baby's breathing.

Most often, bleeding occurs in newborns on the third day of life.. There may be slight or profuse bleeding. The greater the blood loss, the sooner the child’s condition worsens and the lung functions are impaired.

Very premature babies have a very high risk of developing pulmonary hemorrhage. This is due to swelling of the lung tissue and oxygen starvation. This dangerous phenomenon can be caused by intrauterine infection and patent ductus arteriosus.

Bleeding from the lungs is a life-threatening condition that requires urgent medical attention. Bleeding is especially dangerous for newborns who have low body weight.

At strong discharge blood from the patient's lungs is hospitalized. Such a patient must be constantly under the supervision of doctors. They almost always resort to independent nursing intervention, which consists in intravenous administration calcium chloride and the introduction of aminocaproic acid. In addition, cold is applied to the chest.

They occupy first place in frequency of occurrence among other types of pathologies. This is due widespread And a huge amount pathogens respiratory diseases. Special group make up emergency conditions associated with damage to the respiratory system. The greatest danger (after the development of pulmonary embolism) is pulmonary hemorrhage.

What is this condition?

Currently, pulmonary hemorrhage is understood as a symptom complex accompanied by the release of blood into the external environment from affected pulmonary or bronchial vessels. Quite often, bleeding is confused with hemoptysis - the presence of streaks of blood in coughed up sputum. In addition, hemoptysis is a sign of a particular disease, while pulmonary hemorrhage is a combination of several symptoms (which is united by the term “syndrome”).

More often this syndrome accompanies the development of certain pathologies of the respiratory system, or rather, is their complication. It rarely develops as an independent disease.

It poses a huge danger to human life, since if assistance is not provided in a timely manner, death.

Bleeding usually occurs due to pulmonary diseases, birth defects vascular wall or as a result of various provoking factors. What are the reasons for the development of this disease?

Reasons for development

Pulmonary hemorrhage often accompanies diseases of the lung tissue. These include the development of pneumofibrosis (this is facilitated by work in harmful conditions, inhalation of silicate dust, asbestos), tuberculosis (with this pathology, bleeding is a consequence of the destruction of lung tissue). Usually to this pathological phenomenon is given by the infiltrative-destructive form of tuberculosis, although its cause can also be the fibrous-cavernous subtype.

Birth defects vascular system do not occur often. Typically, thinning of the vascular wall is observed, which, with increased pressure in the pulmonary vessels, leads to their rupture and the development of bleeding. Occasionally, aneurysmal dilatations may occur.

In third place in terms of frequency of occurrence are chest injuries. In military field conditions, the most important reason the development of bleeding is barotrauma (subject to a sudden increase in pressure in the respiratory tract with rupture of lung tissue).

Classification of bleeding

For therapy to be successful, you should know about the forms of bleeding and, based on this information, determine treatment tactics.

There are three degrees of this condition:

Mild severity. Usually develops when small bronchial vessels are affected. Up to 100 ml of blood is lost (if it is poured into the lung tissue, it can resolve itself over time). The patient’s condition deteriorates slightly, which is why first aid and premedical measures can be used.

At medium degree severity, hemoptysis and pulmonary hemorrhage are often observed. Up to half a liter of blood is poured into the lumen of the bronchi. If it is not aspirated promptly, pneumonia may develop. Requires treatment at the level of medical care (mainly first and qualified).
If severe bleeding develops, the patient's condition worsens significantly. The volume of blood that escapes the bloodstream exceeds one and a half liters, which leads to anemia, shortness of breath, decreased blood pressure, and tachycardia. The algorithm of care for severe pulmonary hemorrhage involves treatment in specialized medical institutions. Delay in providing it leads to the death of the patient. Such bleeding is almost impossible to stop.

Clinic of the disease

Pulmonary hemorrhage, as has been said, has a number of important symptoms. These include a sudden deterioration in the condition, the release of scarlet blood from the respiratory tract during a cough, and pale skin.

Against the background of normal health, tachycardia, shortness of breath, and decreased blood pressure suddenly appear. The patient usually remembers down to the minute when the condition worsened. In this case, a severe cough develops sharply with the release of bright scarlet blood or copious red sputum. At the same time, pallor of the skin is observed, which indicates a decrease in the volume of blood circulating in the body.

These signs of pulmonary hemorrhage gradually progress, leading to general malaise, weakness and lack of air. If the patient is not provided with medical care, massive bleeding can quickly develop, leading to asphyxia and death. It is because of this similar condition requires immediate medical attention. What events are we talking about?

First aid for pulmonary hemorrhage

So, at the first signs of such a pathological condition, the patient must immediately, without delay, be given first aid. Moreover, this must be done right there, on the spot, while waiting for the ambulance to arrive.

First, you should try to determine what caused the bleeding. If this is a foreign body (and there is a penetrating wound to the chest), then you should not immediately remove it, as this will only worsen the condition.

First aid for pulmonary hemorrhage includes the following measures.

The person must be seated with the body tilted forward or laid down with the head turned to one side. It is best to place the patient on the side on which the pulmonary vessels are expected to be affected (mechanical compression of the lung in the chest will help reduce blood loss).

In the presence of cold objects (a piece of ice, a compress with cold water) should be placed on the chest. Cold can cause spasm of small vessels, which will reduce the volume of blood flowing out.

On this possible help the patient (if the trouble happened on the street) ends. If severe pulmonary hemorrhage occurs, all measures should be carried out by an ambulance team, which immediately upon arrival provides first aid.

Paramedic actions: algorithm for helping with pulmonary hemorrhage

First of all, the responsibilities of a paramedic include the following:

It is necessary to clear the airways, ensure oxygen access and exclude the possibility of blood entering the lungs and lower respiratory tract.
If the patient has intense pain, it is necessary to administer an analgesic (usually drugs such as Promedol or Fentanyl are used).
If there is a drug such as Vikasol, it should be administered intramuscularly.
If there are seizures, it is necessary to administer the medicine “Diazepam” or “Seduxen”.
After providing these measures of first aid, the patient must be taken to a hospital specializing in diseases respiratory system.
If existing signs of pulmonary hemorrhage do not disappear, the risk of developing aspiration pneumonia or suffocation with collapsed lung. In this case, the patient is subject to emergency hospitalization and carrying out the operation.
In no case should the patient's cough be suppressed when providing medical care at this stage. This can lead to passive effusion of blood into the lungs and a significant deterioration of the patient's condition.

Actions for bleeding from pulmonary vessels in a hospital

The algorithm for pulmonary hemorrhage provides mandatory some diagnostic procedures. When a patient is admitted to the hospital, the first step is to perform an emergency bronchoscopy.

This event allows you to determine the condition of the pulmonary vessels and identify the source of bleeding. If the cause of the vessel damage is a tumor, during bronchoscopy it is possible to take a piece of this tumor for examination.

In addition to bronchoscopy, if pulmonary hemorrhage has developed, diagnosis should also include a chest x-ray in two projections. At in serious condition patient, this study can be neglected. The image allows you to determine the presence of blood in pleural cavity or the development of aspiration pneumonia.

After receiving and studying the results, the doctor’s further algorithm of actions is determined:

If there is bleeding from small vessels accessible when viewed through a bronchoscope, they resort to conservative management of the patient, without surgical intervention.
If a large pulmonary vessel is damaged and severe pulmonary hemorrhage develops, the symptoms of which do not disappear despite emergency care, the only way out The only way to save the patient’s life is an emergency operation, since delay can be fatal.

Conservative patient management

As was said, with minor damage to the vessel that causes bleeding, you can manage with conservative and medicinal methods.

The first group includes the forced position of the patient and some limitation of chest excursion. This leads to a decrease in blood flow to the lungs, which is a prerequisite for stopping bleeding.

Medical care for pulmonary hemorrhage includes the use of the following drugs:

To reduce total pressure The drug “Benzohexonium” is used in both the systemic and pulmonary circulation. It is administered intramuscularly (if not this drug, you can use the product “Pentamine”).
“Dicynon” is a drug that promotes the formation of thromboplastin and stops pulmonary hemorrhage. Administered intravenously or intramuscularly.
“Adroxon” is a hemostatic drug administered intramuscularly
In case of significant blood loss, transfusion of blood products (erythrocyte mass) or plasma (it is preferred) is indicated.
“Aminocaproic acid.” This tool administered intravenously. Its action is aimed at the formation of fibrin - the main substance underlying the blood clot.

In parallel, to stop bleeding, coagulation of damaged vessels can be performed (provided that they are accessible and can be reached through the bronchus).

If these methods fail to stop pulmonary hemorrhage, emergency care should be carried out in the surgery department.

Emergency surgical care

If the patient's condition is extremely serious and there is a threat to life, it is necessary to carry out emergency surgery. Help with pulmonary hemorrhage in this case involves removing the affected part of the lung.

The scope of the operation may be different - it can be deleted either lung segment, or whole share. In the most severe cases, a total pneumonectomy (removal of the entire lung) is performed.

Such an intervention falls into the category of complex and traumatic operations.

Removing a segment or even a lobe of the lung is usually successful. In the late postoperative period, the development of respiratory failure is rarely observed, since the missing volume of lung tissue is compensated by a slight increase in the remaining parts or a paired organ.

In a total pneumonectomy, the patient is left with only one lung. If you follow medical instructions, stop smoking and carefully prevent respiratory diseases, even one lung can serve the patient for quite a long time. Respiratory failure will develop in any case, and main goal patient - to delay its appearance as much as possible.

Tactics of behavior in the development of such conditions

As a rule, not all people know how to help a victim if he has massive blood loss from the pulmonary vessels.

First of all, try not to get nervous or fuss. You should act in strict accordance with the above algorithms and not give in to panic. The main thing for an ignorant person is to suspect in time that there is bleeding from the pulmonary vessels. It's quite easy to define:

The blood released from the respiratory tract has a bright scarlet color. Unlike pulmonary bleeding, gastric bleeding will be manifested by vomiting “coffee grounds” (the food eaten, when blood is released from the stomach, reacts with gastric juice, which gives a specific color to the vomit).
Esophageal bleeding usually develops when swallowing unchewed, large food (traumatic rupture of the esophagus) or in the presence of a disintegrating tumor. The blood is predominantly dark in color (due to the fact that it is mainly the venous vessels filled with unoxygenated blood that bleed, while in pulmonary hemorrhage the said fluid is abundantly saturated with oxygen, which gives it a scarlet color).

When symptoms appear, you must first call an ambulance, and before it arrives, provide the patient with all possible assistance. This is very dangerous pathology- pulmonary hemorrhage. Emergency care (the algorithm of measures is described above) is aimed at alleviating the patient’s condition; qualified doctors take on all the main work.

Delay in this case is tantamount to death. And these are not empty words. Untimely assistance provided leads to progression of the underlying disease and complications, and failure to provide necessary measures most often leads to death. Do not be indifferent to the fate of others!

Blood admixtures are found in the sputum, this indicates pulmonary hemorrhage, which occurs due to serious inflammatory processes respiratory system. If you ignore this reaction, you can bring your body to a critical state, which can lead to death. Pulmonary hemorrhage can occur in both adults and newly born babies. Therefore, it is important to know how to provide first aid in this situation.

Basic concept of pulmonary hemorrhage

Under no circumstances should you:

Bath the patient, even in the shower.
Install mustard plasters or jars.
Do hot on the chest.
Don't give it anything to drink.

This is only first aid, thanks to which the patient can safely wait for the doctor to arrive. The main thing is to stick correct sequence actions.

Pulmonary hemorrhage in infants

Unfortunately, pulmonary hemorrhage in infants has become common today. The causes are:

difficult birth
lung
various heart pathologies
hypothermia
asphyxia
premature baby

Thanks to modern achievements, the newborn is brought in very quickly normal condition, so parents shouldn’t panic too much.

If a pregnant woman passes on time medical examination, then the likelihood of having a child with such a pathology is minimal. Need to keep an eye on correct breathing the baby is still in the womb. Problems such as scleredema and hypoglycemia can be noticed in the development of the fetus.

Diagnostics

From correct diagnosis depends quick recovery patient, so it is very important to allocate the proper time and resources for this. The most effective methods diagnostics are:

General examination by several specialists
Coagulogram
Auscultation
Lung ultrasound and x-ray
Magnetic resonance imaging
Angiopulmonography
Computed tomography
Bronchial arteriography
Echocardiography, which allows to exclude the presence of mitral stenosis
General analysis of urine and blood
Biopsy sampling analysis
They take sputum to check for tubercle bacilli and study the etiology of bleeding
PCR – analysis for the presence of viruses, bacteria and microbes in single cells

Bronchoscopy is also performed. The rinsing water is collected, then the pathology is checked for a biopsy, and as a result, a manipulation is performed to stop the bleeding.

X-ray diagnostics - performed lung image. A special substance is injected into peripheral artery through a catheter and a photo is taken. It is easy to find the location of the damage.

After diagnosis, the specialist makes a specific diagnosis and, in accordance with this, prescribes drug treatment. If necessary, surgery is performed.

So, if during a cough or voluminous bleeding, you must go to the hospital immediately. This condition may indicate various diseases.

Mar 2, 2017 Violetta Doctor