Hemoptysis

Composed of two Greek words (“heima”-blood and “ptysis”-spitting), hemoptysis is a symptom that alarms the patient. If the hemoptysis is not massive, there is time to investigate the underlying disease. Massive hemoptysis is life-threatening. It has serious mortality and morbidity. In this article, the latest developments in the hemoptysis approach will be discussed. Hemoptysis is the expectoration of blood or mixed secretions from the lower respiratory tract. The amount may be small or in amounts that can cause death. Sputum mixed with mucus, thick, sticky, blackish, and sour, is called bloody sputum (hemopteic krasha). Life-threatening bleeding is defined as massive hemoptysis. Massive hemoptysis, which constitutes 5-15% of all hemoptysis, requires urgent intervention. For massive bleeding, different amounts are reported as 200-1000 ml bleeding in 24 hours, more than 200 ml in 2 hours, and more than 600 ml in 24 hours in different sources. Definitions for this non-standardized amount of bleeding do not always reflect the clinical characteristics of the patient. For example, the acute situation caused by 200 mL blood expectoration in the last 10 minutes, and 200 mL expectoration spread throughout the day cause different clinical pictures and require different interventions. For this reason, today, the definition is made by considering the clinical characteristics of the patient. Any amount of hemoptysis leading to a life-threatening condition such as respiratory failure or hypotension is recommended to be defined as massive hemoptysis (life-threatening hemoptysis).