Hemodynamic stabilization

Two large-bore intravenous cannulas should be placed to allow fluid access and administration of medication. In a few patients, survival is threatened by the actual volume of blood lost through hemoptysis. Intravenous fluid should be administered commensurate with the vital signs. Routine laboratory analysis should include a hematocrit, platelet count, coagulation profile, arterial blood gases, and renal function studies. Blood should also be typed and cross-matched in case transfusion is required. Any coagulation defects should be corrected. If there is ongoing massive bleeding despite endobronchial management, vasopressors such as intravenous vasopressin (0.2-0.4 units/min as a continuous infusion), terlipressin (1-2 mg as a bolus every 6-8 h), or octreotide (50 pg intravenously as a bolus followed by 50 pg/h as a continuous infusion) can be used as a temporary measure.

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