Complications of bronchiectasis
Massive haemoptysis
Massive haemoptysis is defined as more than 250 mL/day. It is normally thought to occur from bronchial arteries around damaged areas of the lung.
Airway protection is important and patients may need intubation in extreme cases. If bleeding is not stopping, involvement of thoracic surgeons or interventional radiologists for further interventions such as bronchial artery embolisation, bronchoscopy-guided tamponade or surgical resection may be required.
Cor pulmonale
Untreated or progressive lung disease can cause high blood pressure in the pulmonary arteries (pulmonary hypertension) which causes right-sided heart failure.
Management of cor pulmonary involves optimising underlying lung disease but can also include supportive measures such as long-term oxygen therapy and diuretics. In extreme cases, a heart-lung transplant may be appropriate.
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