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Hemoptysis

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Vascular Fistula

Patients over 18 years of age presenting with hemoptysis at the Centre Hospitalier Universitaire de Sherbrooke (CHUS) between the periods of 2005 to 2010.

Brian Grondin-Beaudoin, MD

Matthieu Poirier, MD

Amelie Blanchard, MD

Brian Grodin-Beaudoin, MD

The study consist of a retrospective analysis of the etiologies, investigations and outcomes of patients presenting between 2005 to 2010 with hemoptysis in a North-American Tertiary center.

RATIONALE:

Hemoptysis, mild or massive, is worrisome for both patients and physicians. The management is different depending on the causes, which are not well defined for the North American population. Despite the fact that this symptom is commonly reported in clinic, there are only a few studies published on this subject in the North-American population. Tuberculosis was a frequent cause of hemoptysis described in populations overseas, which seems less prevalent in the investigators center.

Also, there are no known official guidelines regarding the investigation and management of hemoptysis. The investigators hypothesized that the use of modern technology in a North American population may result in different findings and provide a more accurate diagnostic approach.

Therefore, the study compares the different etiologies of hemoptysis and investigation modalities used in patients presenting in a North-American tertiary center.

METHOD:

The investigators did a retrospective analysis of medical chart from patients with hemoptysis who visited the investigators center between 2005 and 2010. Each visit has been reviewed individually to describe the characteristics of patients, etiologies of hemoptysis and investigation modalities used. All-cause mortality at 2 years was also recorded.

Descriptive statistical analyses will conducted on the data available.

Etiologies, Investigations and Outcomes of Patients Presenting With Hemoptysis

Etiologies, Investigations and Outcomes of Patients Presenting With Hemoptysis in a North-American Tertiary Center at the Beginning of the 21st Century

Defining the prevalence of pulmonary diseases by measuring the percentage of patients presenting with hemoptysis caused by lung cancer, bronchiectasis, pulmonary embolism, arteriovenous fistula, pneumonia, bronchitis, tuberculosis, mycosis, heart failure, pseudohemoptysis, cryptogenic and other causes.

Determining the sensitivity in obtaining the etiology of the hemoptysis episode of each diagnostic modality that follows : chest X-ray, chest CT-scan and CT-angiography, bronchoscopy, ventilation-perfusion with single-photon emission computed tomography and pulmonary angiography in the diagnosis of different etiologies of hemoptysis.

All-cause mortality at 2 years after the diagnosis of hemoptysis.

Determining the percentage of patients who : never smoked, is an active smoker, former smoker or unknown status.

Determining the average age of the enrolled patients.

Determining the percentage of each gender of the enrolled patients.

Determining the median of the international normalized ratio (INR).

Determining the median of the partial thromboplastin time (PTT).

Determining the average of the platelet count measured per microliter of blood.

Université de Sherbrooke

Medical Doctor

Skin and Connective Tissue Diseases

Ganglion Cysts

Synovial Cyst

Cysts

Mucinoses

Connective Tissue Diseases

Central Nervous System Depressants

All Drugs and Chemicals

Anesthetics

Patient will receive preemptive stellate ganglion blockade (SGB) just before spinal anesthesia.

Patient will not receive preemptive stellate ganglion blockade (SGB).

Patient will receive preemptive stellate ganglion block (SGB) just before spinal anesthesia.

Stellate ganglion block

Ayman M Eldemrdash, MD

Soudy S Hammad, MD

Tarek S Hemaida, MD

Taha T Dardeer, MD

Ahmed A Mohsen, MD

Ahmed K Fathy, MD

Gamal H Shams, MD

The aim of this study is to evaluate the role of stellate ganglion blockade (SGB) for preserving arteriovenous fistula in hemodialysis patients undergoing major lower limb orthopedic surgery.

The best way for dialysis in chronic renal failure (CRF) patients with consideration of feasibility, rate of infection, and patency is hemodialysis by using native access by using arteriovenous fistula (AVF).

Altered calcium and phosphor metabolism in CRF patients would also increase vascular reactivity. Stellate ganglion blockade (SGB) has been used for several years for both diagnosis and treatment of circulatory problems in upper extremity. Recently preemptive SGB has been used in prevention of radial artery spasm in coronary artery patients.

SGB increases blood flow and decrease vascular resistance in the arm. SGB prevents or ameliorates the reactivity of the muscular layer of the RA in response to both surgical manipulation during harvesting the artery and to the potent vasoconstrictor mediators released during surgery

Stellate Ganglion Block for Preserving Arteriovenous Fistula in Hemodialysis Patients Undergoing Major Lower Limb Orthopedic Surgery

Stellate Ganglion Block for Preserving Arteriovenous Fistula in Hemodialysis Patients Undergoing Major Lower Limb Orthopedic Surgery: A Randomized Controlled Trial

The data will be available upon a reasonable request from the corresponding author after the end of study for one year.

Flow rate will be measured on the first day postoperative then on the 7th day.

Peak systolic velocity (PSV) will be measured from radial artery 2 cm. proximal to fistula site, on the first day postoperative then on the 7th day.

End diastolic velocity (EDV) will be measured from radial artery 2 cm. proximal to fistula site, on the first day postoperative then on the 7th day.

Incidence of failure will be measured on the first day postoperative then on the 7th day.

Postoperative adverse reactions such as hematoma, infection, thrombosis, bleeding, and pitosis will be recorded in both groups.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Etiologies, Investigations and Outcomes of Patients Presenting With Hemoptysis	NCT02913365	Hemoptysis Haemoptysis Lung Disease Pneumonia Tuberculosis Bronchiectasis Respiratory Tra... Respiratory Tra... Bronchitis Mycobacterium I... Bronchial Disea... Pulmonary Hemor... Signs and Sympt... Signs and Sympt... Pathologic Proc... Mycosis Hemorrhage Lung Cancer Pulmonary Embol... Arteriovenous F...		18 Years -	Université de Sherbrooke
Stellate Ganglion Block for Preserving Arteriovenous Fistula in Hemodialysis Patients Undergoing Major Lower Limb Orthopedic Surgery	NCT06300658	Stellate Gangli... Arteriovenous F... Hemodialysis Major Lower Lim...	Stellate gangli...	21 Years - 75 Years	Aswan University
Stellate Ganglion Block for Preserving Arteriovenous Fistula in Hemodialysis Patients Undergoing Major Lower Limb Orthopedic Surgery	NCT06300658	Stellate Gangli... Arteriovenous F... Hemodialysis Major Lower Lim...	Stellate gangli...	21 Years - 75 Years	Aswan University

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