Treatment and prognosis of massive hemoptysis in cystic fibrosis.

Massive hemoptysis (volume of expectorated blood ≥300 ml in 24 hours) occurred in 38 (5 per cent) of 728 patients with cystic fibrosis. Twenty-two of the patients were in the midst of a relatively long-lasting flare-up of pulmonary infection. There was no other consistent precipitating event. All but 7 of the patients were admitted after the initial episode and were treated with parenteral antimicrobial drugs. Postural drainage was resumed as rapidly as possible after cessation of acute bleeding. Vitamin K was administered to all patients. Volumes of expectorated blood were as large as 2,500 ml with the initial episode. Blood pressure changes occurred in 4 patients. Five patients received blood transfusions. Bleeding stopped without surgical intervention in all patients, usually within 4 days. The 38 patients had a total of 85 episodes of bleeding. No surgical treatment was undertaken at this center. One patient underwent a lobectomy at another hospital but continued to bleed postoperatively. Ten patients...