Massive hemoptysis is a medical emergency with high mortality presenting several difficult diagnostic and therapeutic challenges. The origin of bleeding and underlying etiology often is not immediately apparent and techniques for management of this dangerous condition necessitate an expedient response. Unlike hemorrhage in other circumstances, a small amount of blood can rapidly flood the airways thereby impairing oxygenation and ventilation leading to asphyxia and consequent cardiovascular collapse. Of paramount importance is early control of the patient's airway and immediate isolation of hemorrhage in an attempt to localize and control bleeding. A coordinated team response is essential to guarantee the best chances of patient survival. Prompt control of the airway and steps to limit the spread of hemorrhage take precedence. Bronchial artery embolization, rigid and flexible bronchoscopy and surgery all serve as potential treatment options to provide definitive control of hemorrhage. Several adjunctive therapies described in recent years may also assist in control of bleeding, although their role is less defined in life-threatening hemoptysis and warrant additional studies. In this concise review, we emphasize the steps necessary, for a systematic approach in the management of life-threatening hemoptysis.

中文翻译：

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管理大咯血

大咯血是一种医疗急症，死亡率高，存在一些诊断和治疗方面的困难。出血的起源和潜在的病因通常不是很明显，管理这种危险状况的技术需要采取权宜之计。与其他情况下的出血不同，少量血液会迅速充斥气道，从而损害氧合和通气，导致窒息和随之而来的心血管衰竭。最重要的是早期控制患者的气道并立即隔离出血以试图定位和控制出血。协调一致的团队响应对于保证患者生存的最佳机会至关重要。及时控制气道和采取措施限制出血扩散是首要任务。支气管动脉栓塞术、刚性和柔性支气管镜检查和手术都可以作为潜在的治疗选择，以提供明确的出血控制。近年来描述的几种辅助疗法也可能有助于控制出血，尽管它们在危及生命的咯血中的作用尚不明确，需要进一步研究。在这篇简明的综述中，我们强调了对危及生命的咯血进行系统管理的必要步骤。