Pulmonary hemorrhage syndrome as a manifestation of disseminated intravascular coagulation: analysis of ten cases

Pulmonary hemorrhage occurred in 7 patients with disseminated intravascular coagulation (DIC) and was reproduced in 3 monkeys when an experimental model for DIC was used. The syndrome was either the chief complaint for which patients entered the hospital, appeared with other coexisting complications of DIC, or occurred just prior to death. Because the onset of dyspnea, tachypnea, hemoptysis, rales, and a diffuse infiltrate on chest x ray film were usually interpreted as infectious processes, therapy for DIC was withheld and the patients' conditions worsened. Pulmonary hemorrhage was the immediate cause of death in almost all patients. It is suggested that the pulmonary hemorrhage syndrome has features in common with other respiratory distress syndromes such as hyaline membrane disease (HMD), pulmonary hypoperfusion, and shock lung.