Pathogenesis, evaluation, and therapy for massive hemoptysis.

Massive hemoptysis is a rare, but life-threatening event. Death from massive hemoptysis is usually due to aspiration of blood. Thus, the initial evaluation should occur simultaneously with efforts to control the patient's airway and respiratory status. Therapeutic interventions can be directed with an understanding of the underlying pathophysiology and estimated rate of blood loss. Surgery remains the definitive therapy. However, more conservative measures can usually control acute bleeding and provide therapeutic alternatives for patients who are not surgical candidates.