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出血,(特に)大量出血 / 多量に出血する
肺の;肺を冒す

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/07 21:41:22」(JST)

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Pulmonary hemorrhage (or "pulmonary haemorrhage") is an acute bleeding from the lung, especially in the upper respiratory tract and the trachea. When evident clinically, the condition is usually massive, associated with bleeding in other sites as well as more than one third of the lungs.^[1] The onset of pulmonary hemorrhage is characterized by oozing of bloody fluid from the nose and endotracheal tube, as well as to a lesser extent in other places, accompanied by rapid worsening of patient respiration, cyanosis and, in severe cases, shock.^[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：初期マネージメント massive hemoptysis initial management
4. 大量喀血の概要 overview of massive hemoptysis
5. 大量喀血：原因 massive hemoptysis causes

English Journal

Comparative proteomic analysis of lung tissue from guinea pigs with leptospiral pulmonary haemorrhage syndrome (LPHS) reveals a decrease in abundance of host proteins involved in cytoskeletal and cellular organization.

Schuller S1, Sergeant K2, Renaut J2, Callanan JJ3, Scaife C4, Nally JE5.
Journal of proteomics.J Proteomics.2015 Jun 3;122:55-72. doi: 10.1016/j.jprot.2015.03.021. Epub 2015 Mar 27.
Leptospiral pulmonary haemorrhage syndrome (LPHS) is a particularly severe form of leptospirosis. LPHS is increasingly recognized in both humans and animals and is characterized by rapidly progressive intra-alveolar haemorrhage leading to high mortality. The pathogenic mechanisms of LPHS are poorly
PMID 25818725

The Role of Viral, Host, and Secondary Bacterial Factors in Influenza Pathogenesis.

Kash JC1, Taubenberger JK2.
The American journal of pathology.Am J Pathol.2015 Jun;185(6):1528-1536. doi: 10.1016/j.ajpath.2014.08.030. Epub 2015 Mar 5.
Influenza A virus infections in humans generally cause self-limited infections, but can result in severe disease, secondary bacterial pneumonias, and death. Influenza viruses can replicate in epithelial cells throughout the respiratory tree and can cause tracheitis, bronchitis, bronchiolitis, diffus
PMID 25747532

Japanese Journal

肺癌術後有瘻性膿胸の繰り返す肺動脈出血に対する肺動脈塞栓術

胸部外科 = The Japanese journal of thoracic surgery 69(2), 95-98, 2016-02
NAID 40020722661

Hidden Disease with Pulmonary Alveolar Hemorrhage

Journal of General and Family Medicine 17(1), 77-82, 2016
NAID 130005140294

Epstein-Barr Virus-positive T-cell Lymphoproliferative Disease Following Umbilical Cord Blood Transplantation for Acute Myeloid Leukemia

Journal of Nippon Medical School 83(1), 35-42, 2016
NAID 130005132782

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

「肺出血」

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