[Bronchial bleeding].
The acute and general management of patients with massive hemoptysis is described. Initial priorities are insuring adequate airway protection, ventilation, and cardiovascular function. Major priorities of ongoing hemoptysis to prevent gas exchange are intubation with a large bore endotracheal tube and protection of nonbleeding lung by selective intubation into nonbleeding main stem bronchus. Once the patient stabilized, bronchoscopic procedure to stop bleeding following by bronchial arterial embolization should be planned. While surgery remains only definitive therapy, it should not be used in the acute emergent setting unless it cannot be avoided. Bronchial artery and other feeding arteries in the chest wall should be shut off before surgery to prevent massive bleeding during operation.