Management of severe acute pulmonary haemorrhage in children

IF 19.9 1区医学 Q1 PEDIATRICS

Lancet Child & Adolescent Health Pub Date : 2025-04-15 DOI:10.1016/S2352-4642(25)00060-4

Alexander I Gipsman MD , Lauren M C Grant MD , Prof Joseph C Piccione DO , Nadir Yehya MD , Char Witmer MD , Lisa R Young MD , Antoinette Wannes Daou MD , Abhay Srinivasan MD , Pelton A Phinizy MD

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引用次数: 0

Abstract

Pulmonary haemorrhage is a potentially life-threatening condition with a variety of causes. Quality clinical trials are insufficient in children, restricting the evidence base to observational data and adult studies. The overall management strategy should address control of symptomatic bleeding, identification of the bleeding source, and treatment of the underlying cause. Flexible bronchoscopy is an important tool used to identify the cause and site of bleeding, do interventional procedures, and directly instil medications to affected areas. Medications to control bleeding include vasoconstrictors, antifibrinolytics, and recombinant factor VIIa. Definitive treatment often requires immunomodulatory medications, bronchial artery embolisation, or surgery. In this Review, we summarise the most recent evidence pertaining to medical, interventional, and surgical treatments of pulmonary haemorrhage in children.

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儿童严重急性肺出血的处理

肺出血是一种可能危及生命的疾病，病因多种多样。高质量的儿童临床试验不足，证据基础仅限于观察性数据和成人研究。总体管理策略应包括控制症状性出血、确定出血来源和治疗根本原因。柔性支气管镜检查是一种重要的工具，用于确定出血的原因和部位，进行介入手术，并直接向受影响的部位注入药物。控制出血的药物包括血管收缩剂、抗纤溶剂和重组via因子。最终治疗通常需要免疫调节药物、支气管动脉栓塞或手术。在这篇综述中，我们总结了有关儿童肺出血的医学、介入和手术治疗的最新证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lancet Child & Adolescent Health Psychology-Developmental and Educational Psychology

CiteScore

40.90

自引率

0.80%

发文量

381

期刊介绍： The Lancet Child & Adolescent Health, an independent journal with a global perspective and strong clinical focus, presents influential original research, authoritative reviews, and insightful opinion pieces to promote the health of children from fetal development through young adulthood. This journal invite submissions that will directly impact clinical practice or child health across the disciplines of general paediatrics, adolescent medicine, or child development, and across all paediatric subspecialties including (but not limited to) allergy and immunology, cardiology, critical care, endocrinology, fetal and neonatal medicine, gastroenterology, haematology, hepatology and nutrition, infectious diseases, neurology, oncology, psychiatry, respiratory medicine, and surgery. Content includes articles, reviews, viewpoints, clinical pictures, comments, and correspondence, along with series and commissions aimed at driving positive change in clinical practice and health policy in child and adolescent health.