関: lung hemorrhage、pulmonary hemorrhage

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/10/18 02:24:14」(JST)

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Pulmonary hemorrhage (or pulmonary haemorrhage) is an acute bleeding from the lung, from the upper respiratory tract and the trachea, and the alveoli. When evident clinically, the condition is usually massive.^[1] The onset of pulmonary hemorrhage is characterized by cough productive of blood (hemoptysis) and worsening of oxygenation leading to cyanosis.^[1] Treatment should be immediate and should include tracheal suction, oxygen, positive pressure ventilation, and correction of underlying abnormalities (e.g. disorders of coagulation). A blood transfusion may be necessary.^[1]

Incidence

The outcome of treatment is dependent on causality. Pulmonary Hemorrhage is present in 7 to 10% of neonatal autopsies, but up to 80% of autopsies of very preterm infants.^[1] The incidence is 1 in 1,000 live births.^[1] Pulmonary hemorrhage has a high mortality rate of 30% to 40%.^[1]

Causes

Infant prematurity is the factor most commonly associated with pulmonary hemorrhage. Other associated factors are those that predispose to perinatal asphyxia or bleeding disorders, including toxemia of pregnancy, maternal cocaine use, erythroblastosis fetalis, breech delivery, hypothermia, infection, Infant respiratory distress syndrome (IRDS), administration of exogenous surfactants (in some studies) and Extracorporeal membrane oxygenation (ECMO).^[1]

Pathogenesis

Although the pathogenesis is uncertain, it is probable that the symptoms are a consequence of hemorrhagic pulmonary edema, as the hematocrit is lower than normal blood (usually 15-20% less) and the concentration of small proteins is higher than in plasma.^[1] It is postulated that the infant suffers from asphyxia with resultant heart attack; this increases pulmonary microvascular pressure, resulting in pulmonary edema.^[1] Contributing factors include factors that favor increased filtration of fluid from pulmonary capillaries (e.g., low concentration of plasma proteins, high alveolar surface tension, lung damage, hypervolemia).^[1]

Diffuse alveolar hemorrhage

Diffuse alveolar hemorrhage is bleeding from many alveoli throughout the lungs. Common causes include autoimmune diseases and connective tissue diseases.^[2]

References

^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j Pulmonary Hemorrhage Intensive Care Nursery House Staff Manual. UCSF Children's Hospital at UCSF Medical Center. 2004:The Regents of the University of California. Retrieved 2008-10-28.
^ Ioachimescu, O. C.; Stoller, J. K. (2008). "Diffuse alveolar hemorrhage: Diagnosing it and finding the cause". Cleveland Clinic journal of medicine. 75 (4): 258, 260, 264–5 passim. doi:10.3949/ccjm.75.4.258. PMID 18491433.

External links

Cleveland Clinic
MedEd at Loyola medicine/pulmonar/cxr/atlas/wegner4.htm

UpToDate Contents

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1. 成人における喀血の病因および評価 etiology and evaluation of hemoptysis in adults
2. 小児における喀血 hemoptysis in children
3. 大量喀血の概要 overview of massive hemoptysis
4. 大量喀血：原因 massive hemoptysis causes
5. びまん性肺胞出血症候群 the diffuse alveolar hemorrhage syndromes

English Journal

Role of high-resolution computerized tomography chest in identifying tubercular etiology in patients diagnosed as Eales' disease.

Kharel Sitaula R1, Iyer V2, Noronha V3, Dutta Majumder P4, Biswas J5.
Journal of ophthalmic inflammation and infection.J Ophthalmic Inflamm Infect.2017 Dec;7(1):4. doi: 10.1186/s12348-016-0120-1. Epub 2017 Jan 18.
BACKGROUND: The high resolution computerized tomography of chest is an important diagnostic imaging tool to identify any pulmonary tubercular lesion. It's role in Eales' disease to identify any possible association with pulomonary tuberculosis has not been studied earlier. So, this study was conduct
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PREVALANCE AND INFLUENCE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE ON STROKE OUTCOMES IN HOSPITALIZED STROKE PATIENTS.

Lekoubou A1, Ovbiagele B1.
eNeurologicalSci.eNeurologicalSci.2017 Mar;6:21-24. doi: 10.1016/j.ensci.2016.11.007. Epub 2016 Nov 5.
BACKGROUND: Chronic obstructive pulmonary disease (COPD) and stroke are important causes of death. COPD patients are at higher risk of cerebral hypoxia and aspiration. Yet, relatively little is known about the prevalence of COPD among stroke patients or its impact on outcomes after an index stroke.
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The prognostic significance of serum troponin T levels in Crimean-Congo hemorrhagic fever patients.

Yilmaz H1, Yilmaz G2, Kostakoğlu U3, Yaman H4, Örem A5, Köksal İ2.
Journal of medical virology.J Med Virol.2017 Mar;89(3):408-412. doi: 10.1002/jmv.24454. Epub 2016 Nov 10.
Crimean-Congo Hemorrhagic Fever (CCHF) is a disease transmitted by the Crimean-Congo hemorrhagic fever virus (CCHFV), characterized by severe fever and hemorrhage and with a reported fatality level of 3-30%. Cerebral hemorrhage, gastrointestinal hemorrhage, severe anemia, shock, myocardial infarctio
PMID 26693839

Japanese Journal

2010年全国アンケート調査からみた呼吸器内視鏡の合併症(2次出版)

浅野文祐,青江基,大崎能伸,岡田克典,笹田真滋,佐藤滋樹,鈴木栄一,千場博,藤野昇三,大森一光
気管支学 : 日本気管支研究会雑誌 34(3), 209-218, 2012-05-25
目的.呼吸器内視鏡施行実態と合併症を調査するために,日本呼吸器内視鏡学会は郵送による全国アンケート調査を行った.方法.調査用紙をすべての本学会認定および関連認定の538施設に郵送した.対象. 2010年1年間に施行された呼吸器内視鏡症例(診断的気管支鏡,治療的気管支鏡,局所麻酔下胸腔鏡)で病変,手技別に施行件数,合併症,死亡を症例調査表を使用して調べた.結果. 483施設(89.8%)から回答を得 …
NAID 110009457531

Effects of a synthetic protease inhibitor (gabexate mesilate) and a neutrophil elastase inhibitor (sivelestat sodium) on acid-induced lung injury in rats

Yoshikawa Sumiko,Tsushima Kenji,Koizumi Tomonobu,Kubo Keishi
EUROPEAN JOURNAL OF PHARMACOLOGY 641(2-3), 220-225, 2010-09
… in bronchoalveolar lavage fluid, the HCl-induced increases in total nucleated cell counts, neutrophil counts, optical density at 412 nm as an index of pulmonary haemorrhage, concentrations of albumin and cytokine-induced neutrophil chemoattractant (CINC) were significantly attenuated by either gabexate mesilate or sivelestat sodium treatment. …
NAID 120002721839

ＴＮＦ‐αによる肺傷害に対するヒト尿由来のトリプシン・インヒビターの効果

尾内弘次,工藤重治,倉茂達徳,佐藤仁
北関東医学 52(3), 181-188, 2002
【背景・目的】我々はこれまでの実験結果に基づいてTNF-αによる肺傷害をヒト尿由来のトリプシン・インヒビター(UTI)が抑制または軽減できるかどうかを検討した.【対象と方法】実験にはラットを用いた.ネンブタール麻酔下で尾静脈よりTNF-αを投与したTNF-α群, UTIとTNF-αを同時に投与したUTI・TNF-α群, 生理食塩水を投与したPBS群(コントロール)との3群間で肺傷害の程度を組織学的 …
NAID 130000874585

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リンク元	「lung hemorrhage」
関連記事	「haemorrhage」「pulmonary」

「lung hemorrhage」

Pulmonary hemorrhage
	Micrograph showing a pulmonary haemorrhage. H&E stain.
Classification and external resources
Specialty	pediatrics
ICD-10	P26, R04.8
ICD-9-CM	770.3
eMedicine	article/1002002
	[edit on Wikidata]