Tumuluri R. Pulmonary embolism response team: a new paradigm for the multidisciplinary evaluation and treatment of patients with pulmonary embolus (original) (raw)
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Pulmonary embolism response teams: Purpose, evidence for efficacy, and future research directions
Research and Practice in Thrombosis and Haemostasis
Pulmonary embolism (PE) is a major cause of morbidity and mortality. 1-3 In the United States, there are approximately 900 000 cases of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and PE, every year. Of those, 150 000 to 250 000 are PE-related hospitalizations and 60 000 to 100 000 deaths, making it the third most common cause of cardiovascular death. 4,5 The diagnosis and treatment of acute PE can be challenging, as it has a heterogenous range of presentations, from an asymptomatic incidentally identified PE to one that causes hemodynamic instability or even sudden death. Over the past decade, there has been a surge of
Early-term outcomes of the pulmonary embolism response team
Pakistan Journal of Medical Sciences
Objective: Treatment of pulmonary embolism varies according to the different clinical presentations. Pulmonary embolism response teams (PERT) might improve outcomes of pulmonary embolism with faster evaluation and increased usage of advanced treatment methods. In this study, the effects of PERT for the treatment of pulmonary embolism were investigated. Methods: In this retrospectively analyzed study, patients diagnosed with PE in our hospital between March 1st, 2019 and February 28th, 2022 were included. Patients’ medical records were evaluated according to the treatment procedures and early outcomes. Results: Ninety-eight patients with pulmonary embolism were evaluated by the PERT during the study period. The mean age was 62.8+16.4 years and 59% were male. All patients with intermediate-low risk were treated medically. About 59.2% of the patients were hospitalized. The rate of catheter-directed thrombolysis was 37.8% (n=37). Systemic thrombolytic therapy was performed on two patien...
Management of Acute Pulmonary Embolism With a Pulmonary Embolism Response Team
The Journal of the American Board of Family Medicine
Despite recent advances in the assessment, risk stratification, and treatment of acute pulmonary embolism (PE), it remains a leading cause of cardiovascular morbidity and mortality in the United States each year. Patient presentation and prognosis are heterogeneous, and a variety of diagnostic and therapeutic instruments have arisen to assist in providing patients with the appropriate level of care and aggressiveness of approach. Fortunately, a growing number of institutions now have pulmonary embolism response teams (PERT) that urgently assist with risk assessment and management of patients with massive and sub-massive PE. In service of providers at the point of contact with acute PE, this review aims to summarize the data pertinent to rapid risk assessment and the interpretation of diagnostics used to that end. The role of PERT and the indications for systemic fibrinolysis and invasive therapies are also discussed.
Diagnosis and treatment of acute pulmonary embolism: a single center experience
Acta Medica Alanya, 2022
Amaç: Pulmoner emboli, acil servislerde sıklıkla karşılaşılan, potansiyel olarak yaşamı tehdit eden bir kardiyovasküler hastalıktır. Bilgisayarlı tomografi pulmoner anjiyografi, pulmoner emboli tanısında tercih edilen görüntüleme yöntemidir. Bu çalışmada, acil serviste akut pulmoner emboli tanısı konulan hastaları inceleyerek klinik bulguların ve tedavi yöntemlerinin prognoz ve mortalite üzerine etkilerini incelemeyi amaçladık. Yöntem: Bu retrospektif kohort çalışmada akut pulmoner emboli hastalarının kayıtlarına arşivden ulaşıldı. Hastaların yaşı, cinsiyeti, tıbbi şikayetleri, ek hastalıkları, hastalara uygulanan tedavi yöntemi ve hastaların klinik sonuçları analiz edildi. Hastaların demografik ve klinik bilgilerinin istatistiksel dağılımı hesaplandı. Bulgular: Akut pulmoner embolili 206 hastanın en sık şikayeti nefes darlığıydı. Hastaların %25.7'sinde masif pulmoner emboli vardı. Masif pulmoner emboli hastalarında kan d-dimer, laktat ve troponin T düzeyleri submasif pulmoner emboli hastalarına göre daha yüksek bulundu. Akut pulmoner emboli hastalarının %6.8'ine trombolitik tedavi uygulanmış ve sağ kalımı istatistiksel olarak olumlu etkileyen bir yöntem olduğu saptanmıştır. Mortal hastalarda d-dimer, beyaz küre, nötrofil, kan üre nitrojen, laktat ve troponin T değerleri daha yüksek bulundu. Hastaların %13.1'inin hayatını kaybettiği belirlendi. Sonuç: Acil serviste ölümcül olabilen akut pulmoner emboli ne kadar erken teşhis edilir ve tedavisine başlanırsa mortalite oranı önemli ölçüde azalacaktır.
Management of acute pulmonary embolism: a contemporary, risk-tailored approach
Hellenic journal of cardiology : HJC = Hellēnikē kardiologikē epitheōrēsē
P ulmonary embolism (PE)-associated morbidity and mortality remain high despite important advances in cardiovascular diagnosis and treatment. The reported annual incidence of venous thromboembolism ranges between 23 and 69 cases per 100,000 population, 1,2 with approximately one third of patients presenting with acute PE and two thirds with deep vein thrombosis. 3 Case fatality rates Modified from reference 14 and updated according to recent data. H-FABP-heart-type fatty acid binding protein; MDCT-multidetector computed tomography; PE-pulmonary embolism; RV-right ventricle.
Thrombolytic Therapy for Submassive Pulmonary Embolism?
Annals of Emergency Medicine, 2007
thrombolytics to standard heparin therapy for treatment of submassive pulmonary embolism. Patients with submassive pulmonary embolism were considered to be those with evidence of right ventricular dysfunction but without hemodynamic instability.
Venous Thromboembolism and Pulmonary Embolism Response Teams: An Overview
Critical care nursing quarterly
Venous thromboembolism is a common disease with a wide array of signs and symptoms. It has been cited as the third leading cause of cardiovascular death, and if left untreated, it leads to death in 1 in 4 patients. Sophisticated diagnostic tools have allowed physician to become more accurate in diagnosing pulmonary embolism and deep vein thrombosis. The advent of new oral anticoagulants, the emergence of pulmonary embolism response teams, and protocols demonstrate recent achievements in the management of venous thromboembolism. The focus of this article is to discuss the treatment of venous thromboembolism.
Kardiologia polska, 2021
BACKGROUND A pulmonary embolism response team (PERT) is a multidisciplinary team established to improve clinical care for patients with pulmonary embolism (PE). However, data regarding detailed institutional experience and clinical outcomes from such teams are sparse. AIMS We aim to assess the frequency of activations, patients' characteristics, PE severity, applied treatments, and outcomes of PE patients treated by Polish PERTs. METHODS The survey registry was conducted between June 2018 and July 2020. All consecutive PERT activations of four institutionalized PERTs in Poland were analyzed. Patients' characteristics, therapies applied, and in-hospital outcomes were evaluated. RESULTS There were 680 unique PERT activations. The majority of activations originated from emergency departments (44.9%), and the remaining originated from internal medicine/cardiology units (31.1%), surgery/orthopedics (9.1 %), oncology (6.3%), intensive care units (6.0%), and others (2.5%). The orig...