THERAPEUTIC BRONCHOSCOPY IN HEMOPTYSIS - A STUDY OF 157 PATIENTS AND REVIEW OF LITERATURE

Objectives: To study the role of fibreoptic bronchoscopy (FOB) in the management of hemoptysis. To study the efficacy of different bronchoscopic therapeutic maneuvers. Materials and methods: 157 patients presenting with hemoptysis underwent FOB, out of which bleeding site was localized in 76 patients who were taken for different therapeutic maneuvers through bronchoscope. Control of bleeding was attempted by three methods: instillation of cold saline-epinephrine solution or a topical coagulant (botroclot) through the aspiration channel of the bronchoscope; and a tissue glue, n-butyl cyanoacrylate to the bleeding site through a polythene tube inserted via the bronchoscope. Results: Instillation of cold saline-epinephrine solution via the bronchoscope as a therapeutic measure to control hemoptysis was very effective in 39.4% patients, somewhat effective in 42.4% patients and ineffective in 18.2% patients. Instillation of botroclot was very effective in 45.2% patients, somewhat effective in 35.5% patients and ineffective in 19.3% patients. Instillation of tissue glue n-butyl cyanoacrylate was very effective in 50% patients and somewhat effective in 50% patients. Conclusion: Bronchoscopic therapeutic measures can be effectively used to control hemoptysis to buy time for more definitive therapies.