IBCC Episode 46 - Massive Hemoptysis

In this episode of the Internet Book of Critical Care Podcast, Josh and Adam discuss the approach to identifying and managing severe hemoptysis, emphasizing that patients die from asphyxiation rather than exsanguination. They highlight the importance of keeping blood out of the good lung and containing it in the bad lung, while also preserving the patient's cough reflex if possible. The discussion covers differentiating hemoptysis from pseudohemoptysis, determining who needs ICU care, and identifying common causes such as malignancy, infection, vasculitis, and iatrogenic factors. They explore diagnostic tools like CT scans and lung ultrasounds, as well as interventions such as nebulized tranexamic acid, coagulopathy management, and the timing of intubation. The hosts also discuss the role of bronchoscopy, endobronchial blockers, interventional pulmonology, and surgery in managing severe cases, while touching on diffuse alveolar hemorrhage.