Pulmonary bleeding

At a Pulmonary bleeding there is a leakage of blood from the pulmonary vasculature into the tissue of the lungs. There are numerous sources and causes of bleeding. Pulmonary bleeding is mainly noticeable through bloody sputum when coughing.

What is pulmonary bleeding?

When the lungs hemorrhage, blood leaks from the vessels in the lungs into the surrounding lung tissue. The cause of the bleeding is small or larger vessel lesions. These can be caused by different diseases.

Small lung hemorrhages often go unnoticed, larger bleeding results in blood leaking from the nose or mouth. Massive pulmonary bleeding can severely hinder breathing and thus be life-threatening. They are therefore to be regarded as an emergency and accordingly require emergency medical treatment.

causes

Pulmonary hemorrhage can originate in the bronchi and in the pulmonary functional tissue. If bronchitis is severe, bleeding from the lungs may occur. The most common causes of lung bleeding in men over 45 years of age are lung metastases and lung cancer. Most of these are found in smokers. Bronchiectasis is an expansion of a bronchus. Bronchiectasis can be congenital or acquired through infection and inflammation of the airways.

Coughing up large amounts of foul smelling secretions is characteristic of the disease. The strong urge to cough can burst vessels, so that traces of blood can also be found in this secretion. Foreign bodies can also cause bleeding in the bronchi. Children are particularly often affected. Nuts, marbles and small toy parts in particular are often aspirated by children. Sharp-edged foreign bodies, in particular, can damage blood vessels in the bronchi and cause bleeding.

For a long time the most common cause of bleeding from the functional lung tissue was tuberculosis. The disease is caused by Mycobacterium tuberculosis and primarily damages the lungs, along with other organs. Severe inflammation of the lungs (pneumonia) or a lung abscess can also cause bleeding. Of course, injuries to the lungs such as stab wounds also lead to lung bleeding.

Vessels are more easily destroyed if they are already damaged. Pulmonary embolism, pulmonary hypertension, Goodpasture's syndrome or arteriovenous malformations can cause bleeding through damage to the vessels. Disease conditions which are associated with an increased tendency to bleed also increase the risk of pulmonary bleeding.

These so-called hemorrhagic diatheses include diseases of the blood platelets or diseases of the coagulation factors such as hemophilia, the blood disease. Bleeding in the lungs can also be autoimmune. Systemic lupus erythematosus can manifest itself through blood in the sputum. Other causes of pulmonary bleeding are Osler syndrome, endometriosis, Wegener's disease or a mycetoma.

Pulmonary bleeding is noticeable primarily in the form of coughing up blood. In medical terminology, coughing up blood is also known as hemoptysis or hemoptysis. During hemoptysis, blood-containing sputum is coughed up. The blood threads can be inconspicuous or make the sputum appear slightly pink-red in color. The increase in hemoptysis is hemoptysis. Usually the blood is bright red and covered in foam. Here those affected cough up large amounts of blood.

An oppressive feeling in the chest, palpitations, cough or a salty taste in the mouth can, depending on the cause, be harbingers of bleeding in the lungs. Rather, pulmonary bleeding is a symptom of a medical condition and suggests serious underlying illnesses.

Diseases with this symptom

• lung infection
• Pulmonary hypertension
• Pulmonary embolism
• Wegener's disease
• Osler's disease

• hemophilia
• Goodpasture Syndrome
• Metastases
• tuberculosis
• Cystic fibrosis

• Bronchiectasis
• Lung cancer
• Foreign body aspiration
• bronchitis
• Systemic lupus erythematosus

Diagnosis & course

Various diagnostic methods are used to clarify the pulmonary hemorrhage and to localize the source of the bleeding. Prior to the instrument-based diagnosis, the patient's anamnestic information can provide initial information about the cause of the bleeding. After the anamnesis, a physical examination is first performed. Then the lungs can be examined more closely using an X-ray examination. The localization of the bleeding is often evident here.

A more precise determination is then usually made with the help of bronchoscopy. The lower airways are examined with an endoscope. A high-resolution computer tomography may also be used. It is particularly suitable for diagnosing tissue changes and for localizing tumors.

Complications

Untreated pulmonary bleeding has various complications depending on the cause. In extreme cases, there is danger to life and limb.Massive bleeding can severely restrict aspiration and thus the absorption of vital oxygen within minutes. Affected persons suffer death from suffocation under these circumstances.

With light bleeding such as reddish sputum there is no immediate danger. Nevertheless, serious consequences can develop from this. Fluid deposits in the lungs irritate the tissue there and promote severe inflammation or worsen existing diseases. Tuberculosis or a developing one

Tumors are also possible causes here, which, if left untreated, can have a drastic effect on the life expectancy of a patient. Regular ejections with red additions therefore always belong under medical supervision. If there is excessive discharge of blood from the mouth or nose, the source of which does not appear to be the oral cavity or the upper respiratory tract, seek medical advice immediately.

Depending on the chosen treatment for pulmonary bleeding, intolerance or side effects with the medication may occur. Anticoagulants used to quickly stop extreme bleeding also increase the risk of a blood clot. A relapse through surgical incisions cannot be completely ruled out in severe internal wounds caused by foreign bodies or ulcers. Long-term hospitalization with intensive monitoring until recovery is therefore appropriate.

When should you go to the doctor?

Bleeding from the lungs is the result of a serious illness and requires immediate medical attention. A few typical symptoms can be used to tell whether there is bleeding from the lungs. A doctor must be alerted if there is intense coughing up blood, pain in the lungs or foamy, bloody sputum. Other warning signs are paleness, shortness of breath and an increased heart rate.

If the blood pressure falls below 100/60, this indicates bleeding from the lungs or other serious illness that requires immediate treatment. If there is an accompanying loss of consciousness, first aid measures must be initiated until the rescue service arrives. In principle, complaints with the lungs should be clarified as quickly as possible so that there is no lung bleeding in the first place.

Patients with bronchitis, smoker's cough, pneumonia or lung metastasis should go to the emergency room at the first warning signs such as a noticeable blood odor in the mouth or sharp pain in the lungs. Anyone who has swallowed a foreign body or has lung pain after an accident should also have this clarified quickly in order to avoid serious complications such as pulmonary bleeding.

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Treatment & Therapy

Treatment for pulmonary bleeding depends on the cause. Pneumonia and bronchitis are usually treated with antibiotics for bacterial infections. Antibiotics are also used in tuberculosis. Here, the medication usually has to be administered for months. Carcinomas and metastases of the lungs can be treated with surgery, chemotherapy, or radiotherapy.

Usually, bronchial carcinomas are discovered very late, so that the tumors are often inoperable and can only be treated palliatively. If the pulmonary hemorrhage is caused by a foreign body, it must be removed as quickly as possible from the affected bronchial or lung section. The foreign body removal can be removed either by bronchoscopy or surgical intervention.

Bronchiectasis as the cause of bleeding is very difficult to treat. Therapy is usually conservative with antibiotics and respiratory therapy. In severe cases, surgery may be indicated. Autoimmune pulmonary hemorrhage is usually treated with glucocorticoids and immunosuppressants. A lung transplant may be required if you have severe lung disease, such as advanced pulmonary hypertension.

Outlook & forecast

The prognosis for lung haemorrhage depends on the type and severity of the underlying condition. Untreated pulmonary hemorrhage brings various complications and can lead to aspiration and subsequent death from suffocation. In less severe cases, fluid may build up in the lungs, which can irritate the affected tissue and cause severe inflammation.

Serious causes such as bronchial carcinoma are usually discovered late and can often only be treated palliatively. With autoimmune bleeding from the lungs, similar symptoms can occur again and again after recovery. If pulmonary haemorrhage is treated when the underlying disease is still in its early stages, there is a prospect of rapid recovery.

If the lungs are bleeding as a result of an infection, the symptoms can be treated with antibiotics; If the bleeding is caused by a carcinoma or tumor, surgery or chemotherapy is necessary. Patients who have swallowed a foreign body have the best prospects. Long-term consequences are unlikely if there is rapid surgery or bronchoscopy. However, only a doctor can give a final prognosis, as the prospect of lung bleeding depends on various factors.

prevention

Not all pulmonary bleeding can be prevented. The most important preventive measure is certainly not smoking. Smokers have a significantly higher risk of lung disease than non-smokers. Lung carcinomas, in particular, are particularly common in smokers. If the lung is already damaged, further infections should be avoided.

It is advisable to prevent possible complications of an infection with a flu vaccination in patients with a lung disease. Of course, the vaccination does not prevent other diseases. Therefore, the patient's immune system should also be strengthened.

You can do that yourself

Bleeding from the lungs is a symptom of a serious illness and requires immediate medical attention. Until the emergency doctor arrives, the lungs should be spared if possible. If the cough is bloody, swallowing should be avoided to prevent more blood from entering the throat. It is also advisable to stay calm and check the symptoms.

If there is also a palpitations, an oppressive feeling or a salty taste in the mouth, there is bleeding from the lungs. If the sputum is bloody, there may be another cause, but this does not have to be less serious than bleeding from the lungs. In the event of pulmonary bleeding, those affected should sit in a semi-sitting position and, if possible, not put any further strain on the lungs until the emergency services arrive. Patients with a lung disease and people with a weakened immune system or other health problems are also recommended to take a course in emergency care.

After a lung hemorrhage, it is important to strengthen the immune system and prevent possible infections with a vaccination. In general, a healthy lifestyle reduces the risk of bleeding from the lungs and, in the event of bleeding, the risk of complications.