Respiratory bleeding - Haemoptysis

Medium urgency
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Expulsion of blood through the mouth that comes from the respiratory system; it must be differentiated from blood coming from the digestive system. It is considered to be severe when the volume is greater than 150-600m or has clinical consequences.

There are multiple causes among which the following stand out: infections, cancer, cardiovascular disease and traumas.

It presents with coughing up blood that is bright red and frothy as it is coughed up with air.

The diagnosis is clinical, by observing the blood coming out together with the cough. A detailed medical history and physical examination are required, as well as blood tests, chest X-ray and electrocardiogram. Additional imaging tests will assist in determining the point of bleeding and, occasionally may become part of the treatment: bronchoscopy, CT-scan and, in some patients, bronchial arteriogram.

Treatment should ensure clinical stability by serum therapy, correction of clotting factors and blood transfusion. Depending on the cause, treatment may include bronchial endoscopy, arteriography with arterial embolisation or surgery.

Bibliographic references
  1. Steven E Weinberger. Etiology and evaluation of hemoptysis in adults. UpToDate. Jun 01, 2016.
  2. Dave BR, Sharma A, Kalva SP, Wicky S. Nine-year single-center experience with transcatheter arterial embolization for hemoptysis: medium-term outcomes. Vasc Endovascular Surg 2011; 45:258.
  3. Savale L, Parrot A, Khalil A, et al. Cryptogenic hemoptysis: from a benign to a life-threatening pathologic vascular condition. Am J Respir Crit Care Med 2007; 175:1181.
  4. Jean-Baptiste E. Clinical assessment and management of massive hemoptysis. Crit Care Med 2000; 28:1642.
  5. Patricia A. Kritek, Christopher H. Fanta. Tos y hemoptisis. Harrison. Principios de Medicina Interna. Volumen 1. 19º Edición. 243: 247
  6. María Martín-Toledano Lucas, Encarna López Gabaldón, Ángel Sánchez Castaño. Hemoptisis. Manual de protocolos y actuación en urgencias. Hospital Virgen de la Salud, Complejo Hospitalario de Toledo. Tercera edición. 2010. 355:360
Author
Dr. Elvira Moreno
Copyright
© TeckelMedical 2026

Symptoms

    Coughing up blood


    Short of breath


    Paleness


    Shortness of breath at rest


    Cough

Pre-hospital care recommendations

Remain calm.
Maintain hydration of 2 litres per day.