Management

• Basic resuscitation (high FIO2, endotracheal intubation and bloodtransfusion) is needed for cardiorespiratory compromise.

• Correction of coagulopathy is a priority.

• Bronchoscopy allows direct instillation of 1 in 200,000 epinephrine if the source of haemorrhage can be found or, alternatively, endobronchial tamponade with a balloon catheter.

• In cases of severe haemorrhage from one lung a double lumen endotracheal tube may prevent some overspill to the other lung while definitive treatment is organised.

• Definitive treatment may include radiological bronchial artery embolisation, or surgical resection.

• Induced hypotension may be useful in bronchial artery haemorrhage.

• In cases of pulmonary artery haemorrhage, PEEP may be used with mechanical ventilation to reduce pulmonary bleeding.

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