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Pulmonary embolism response team

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https://www.readbyqxmd.com/read/29872247/patient-assessment-clinical-presentation-imaging-diagnosis-risk-stratification-and-the-role-of-pulmonary-embolism-response-team
#1
REVIEW
Tamir Friedman, Ronald S Winokur, Keith B Quencer, David C Madoff
Pulmonary embolism (PE) is currently the third leading cause of death and moreover is likely underdiagnosed. PE remains the most common preventable cause of hospital deaths in the United States, which may be attributable to its diagnostic challenges. Although difficult to diagnose, patient mortality rates are time-dependent, and thus, the suspicion and diagnosis of PE in a timely manner is imperative. Diagnosis based on several criteria which may dictate imaging workup as well as laboratory tests and clinical parameters are discussed...
June 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29789172/the-role-of-the-pulmonologist-in-a-pulmonary-embolism-response-team-pert-a-time-to-come-on-stage
#2
Diego A Rodríguez Chiaradía, Michael J Cuttica, David Jimenez
No abstract text is available yet for this article.
May 19, 2018: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/29786477/the-impact-of-a-multi-specialty-team-for-high-risk-pulmonary-embolism-on-resident-and-fellow-education
#3
Ayman Elbadawi, Colin Wright, Dhwani Patel, Yu Lin Chen, Justin Mazzillo, Pamela Cameron, Geoffrey D Barnes, Scott J Cameron
The impact of the Pulmonary Embolism Response Team (PERT) model on trainee physician education and autonomy over the management of high risk pulmonary embolism (PE) is unknown. A resident and fellow questionnaire was administered 1 year after PERT implementation. A total of 122 physicians were surveyed, and 73 responded. Even after 12 months of interacting with the PERT consultative service, and having formal instruction in high risk PE management, 51% and 49% of respondents underestimated the true 3-month mortality for sub-massive and massive PE, respectively, and 44% were unaware of a common physical exam finding in patients with PE...
May 1, 2018: Vascular Medicine
https://www.readbyqxmd.com/read/29672125/submassive-pulmonary-embolism
#4
Parth M Rali, Gerard J Criner
Pulmonary Embolism (PE) presents a spectrum of hemodynamic consequences ranging from being asymptomatic to a life-threatening medical emergency. Management of sub massive and massive PE often involves clinicians from multiple specialties that can potentially delay the development of a unified treatment plan. Additionally, patients with submassive PE can deteriorate after their presentation and require escalation of care. Underlying comorbidities like chronic obstructive pulmonary disease (COPD), cancer, congestive heart failure and interstitial lung disease can impact the patient's hemodynamic ability to tolerate submassive PE...
April 19, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29670358/multidisciplinary-approach-to-the-management-of-pulmonary-embolism-patients-the-pulmonary-embolism-response-team-pert
#5
REVIEW
Christopher W Root, David M Dudzinski, Bishoy Zakhary, Oren A Friedman, Akhilesh K Sista, James M Horowitz
Pulmonary embolism (PE) is a potentially fatal disease with a broad range of treatment options that spans multiple specialties. The rapid evolution and expansion of novel therapies to treat PE make it a disease process that is well suited to a multidisciplinary approach. In order to facilitate a rapid, robust response to the diagnosis of PE, some hospitals have established multidisciplinary pulmonary embolism response teams (PERTs). The PERT model is based on existing multidisciplinary teams such as heart teams and rapid response teams...
2018: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/29667126/treatment-of-submassive-and-massive-pulmonary-embolism-a-clinical-practice-survey-from-the-second-annual-meeting-of-the-pulmonary-embolism-response-team-consortium
#6
Thomas M Todoran, Jay Giri, Geoffrey D Barnes, Rachel P Rosovsky, Yuchiao Chang, Michael R Jaff, Kenneth Rosenfield, Christopher Kabrhel
There is a paucity of robust clinical trial data to guide the treatment of acute pulmonary embolism (PE) thus the clinical guidelines rely heavily on expert opinion. Pulmonary Embolism Response Teams (PERT) have been developed to streamline the care of patients with acute PE. We conducted a survey among 100 experts in the field of PE during the second annual meeting of the PERT Consortium. Respondents were queried with respect to their demographic information, clinical practice questions and clinical vignettes...
July 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29659045/surgical-pulmonary-embolectomy-and-catheter-directed-thrombolysis-for-treatment-of-submassive-pulmonary-embolism
#7
Ahmed A Kolkailah, Sameer Hirji, Gregory Piazza, Julius I Ejiofor, Fernando Ramirez Del Val, Jiyae Lee, Siobhan McGurk, Sary F Aranki, Prem S Shekar, Tsuyoshi Kaneko
BACKGROUND: Acute pulmonary embolism (PE) with preserved hemodynamics but right ventricular dysfunction, classified as submassive PE, carries a high risk of mortality. We report the results for patients who did not qualify for medical therapy and required treatment of submassive PE with surgical pulmonary embolectomy and catheter-directed thrombolysis (CDT). METHODS: Between October 1999 and May 2015, 133 submassive PE patients underwent treatment with pulmonary embolectomy (71) and CDT (62)...
May 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29532200/oocyte-cryopreservation-for-women-with-gata2-deficiency
#8
Jessica R Zolton, Toral P Parikh, Dennis D Hickstein, Steven M Holland, Micah J Hill, Alan H DeCherney, Erin F Wolff
PURPOSE: To describe controlled ovarian stimulation (COS) in a population of women with GATA2 deficiency, a genetic bone marrow failure syndrome, prior to allogeneic hematopoietic stem cell transplant METHODS: This is a retrospective case series of nine women with GATA2 deficiency who underwent oocyte preservation at a research institution. Main outcomes measured include baseline fertility characteristics ((antimullerian hormone (AMH) and day 3 follicle-stimulating hormone (FSH) and estradiol (E2)) and total doses of FSH and human menopausal gonadotropins (HMG), E2 on day of trigger, and total number of metaphase II oocytes retrieved...
March 13, 2018: Journal of Assisted Reproduction and Genetics
https://www.readbyqxmd.com/read/29511564/management-of-patients-with-high-risk-pulmonary-embolism-a-narrative-review
#9
REVIEW
Takeshi Yamamoto
High-risk pulmonary embolism (PE) is a life-threatening disorder associated with high mortality and morbidity. Most deaths in patients with shock occur within the first few hours after presentation, and rapid diagnosis and treatment is therefore essential to save patients' lives. The main manifestations of major PE are acute right ventricular (RV) failure and hypoxia. RV pressure overload is predominantly related to the interaction between the mechanical pulmonary vascular obstruction and the underlying cardiopulmonary status...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29354208/endovascular-treatment-of-pulmonary-embolism-selective-review-of-available-techniques
#10
REVIEW
John L Nosher, Arjun Patel, Sugeet Jagpal, Christopher Gribbin, Vyacheslav Gendel
Acute pulmonary embolism (PE) is the third most common cause of death in hospitalized patients. The development of sophisticated diagnostic and therapeutic modalities for PE, including endovascular therapy, affords a certain level of complexity to the treatment of patients with this important clinical entity. Furthermore, the lack of level I evidence for the safety and effectiveness of catheter directed therapy brings controversy to a promising treatment approach. In this review paper, we discuss the pathophysiology and clinical presentation of PE, review the medical and surgical treatment of the condition, and describe in detail the tools that are available for the endovascular therapy of PE, including mechanical thrombectomy, suction thrombectomy, and fibrinolytic therapy...
December 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/29034789/a-midterm-report-card-for-pulmonary-embolism-response-teams
#11
COMMENT
Jay S Giri, Gregory Piazza
No abstract text is available yet for this article.
February 2018: Vascular Medicine
https://www.readbyqxmd.com/read/29029717/the-role-of-the-pulmonary-embolism-response-team-how-to-build-one-who-to-include-scenarios-organization-and-algorithms
#12
Andrew Galmer, Ido Weinberg, Jay Giri, Michael Jaff, Mitchell Weinberg
Pulmonary embolism response teams (PERTs) are multidisciplinary response teams aimed at delivering a range of diagnostic and therapeutic modalities to patients with pulmonary embolism. These teams have gained traction on a national scale. However, despite sharing a common goal, individual PERT programs are quite individualized-varying in their methods of operation, team structures, and practice patterns. The tendency of such response teams is to become intensely structured, algorithmic, and inflexible. However, in their current form, PERT programs are quite the opposite...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029711/surgical-embolectomy-for-massive-and-submassive-pulmonary-embolism-and-pulmonary-thromboendarterectomy-for-chronic-thromboembolic-pulmonary-hypertension
#13
REVIEW
Richard J Shemin
Surgical therapy for massive acute pulmonary embolism has improved with the use of rapid response teams and selective bedside extracorporeal membrane oxygenation initiation. The chronic consequence of unresolved pulmonary embolism is a treatable form of pulmonary hypertension. Pulmonary thromboendarterectomy is a curative operation in selected cases, operated upon in an experienced center with the multidisciplinary team including imaging, pulmonary medicine, and cardiothoracic surgery.
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029706/pulmonary-embolism-in-2017-how-we-got-here-and-where-are-we-going
#14
REVIEW
Geno J Merli
In the 1970s, both the Urokinase Pulmonary Embolism and Urokinase-Streptokinase Pulmonary Embolism trials began the quest to develop thrombolytic therapy for the treatment of acute massive and submassive pulmonary embolism (PE). The goals of these studies were the immediate reduction in clot burden, restoration of hemodynamic stability, and improved survival. Major bleeding became the major barrier for clinicians to employ these therapies. From 1980s to the present time, a number of studies using recombinant tissue-type plasminogen activator for achieving these same above outcomes were completed but major bleeding continued to remain an adoption barrier...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28983441/high-value-care-in-the-evaluation-of-stroke
#15
Prakrity Urja, Eric H Nippoldt, Virginia Barak, Carrie Valenta
Value-based care emphasizes achieving the greatest overall health benefit for every dollar spent. We present an interesting case of stroke, which made us consider how frequently health care providers are utilizing value-based care. A 73-year-old Caucasian, who was initially admitted for a hypertensive emergency, was transferred to our facility for worsening slurring of speech and left-sided weakness. The patient had an extensive chronic cerebrovascular disease, including multiple embolic type strokes, mainly in the distribution of the right temporal-occipital cerebral artery and transient ischemic attacks (TIAs)...
August 1, 2017: Curēus
https://www.readbyqxmd.com/read/28920554/a-pulmonary-embolism-response-team-s-initial-20-month-experience-treating-87-patients-with-submassive-and-massive-pulmonary-embolism
#16
Akhilesh K Sista, Oren A Friedman, Eda Dou, Brendan Denvir, Gulce Askin, Jamie Stern, Jaclyn Estes, Arash Salemi, Ronald S Winokur, James M Horowitz
Pulmonary Embolism Response Teams (PERTs) have emerged to provide rapid multidisciplinary assessment and treatment of PE patients. However, descriptive institutional experience and preliminary outcomes data from such teams are sparse. PERT activations were identified through a retrospective review. Only confirmed submassive or massive PEs were included in the data analysis. In addition to baseline variables, the therapeutic intervention, length of stay (LOS), in-hospital mortality, and bleeding rate/severity were recorded...
February 2018: Vascular Medicine
https://www.readbyqxmd.com/read/28831930/-pulmonary-embolism-response-teams-what-is-the-added-value-for-patients-with-acute-pulmonary-embolism
#17
M V Huisman, J M Montero Cabezas, F A Klok
Adequate triaging of patients presenting with acute pulmonary embolism (PE) is essential for appropriate treatment, especially for patients with severe PE. Optimal treatment for this latter group of patients includes pharmaco-mechanical reperfusion treatment for the minority of patients who present with haemodynamic instability, and standard anticoagulation and close monitoring on the ward for the intermediate-high risk patient. In the USA, pulmonary embolism response teams (PERT) have been introduced to coordinate triaging of these patients...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28807405/initiation-of-a-multidisciplinary-rapid-response-team-to-massive-and-submassive-pulmonary-embolism
#18
Brett J Carroll, Heather Pemberton, Kenneth A Bauer, Louis M Chu, Jeffrey L Weinstein, Barbara L Levarge, Duane S Pinto
Pulmonary embolism (PE) can result in rapid clinical decompensation in many patients. With increasing patient complexity and advanced treatment options for PE, multidisciplinary, rapid response teams can optimize risk stratification and expedite management strategies. The Massive And Submassive Clot On-call Team (MASCOT) was created at our institution, which comprised specialists from cardiology, pulmonology, hematology, interventional radiology, and cardiac surgery. MASCOT offers rapid consultation 24 hours a day with a web-based conference call to review patient data and discuss management of patients with high-risk PE...
October 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28650086/systemic-thrombolysis-catheter-directed-thrombolysis-and-anticoagulation-for-intermediate-risk-pulmonary-embolism-a-simulation-modeling-analysis
#19
COMPARATIVE STUDY
Christopher Kabrhel, Ayman Ali, Jin G Choi, Chin Hur
OBJECTIVES: Decision making around the use of thrombolysis for patients with intermediate-risk (submassive) pulmonary embolism (PE) remains challenging. Studies indicate favorable clinical outcomes with systemic thrombolytics (intravenous tissue plasminogen activator [IV tPA]), but the risk of major bleeding and hemorrhagic stroke is a deterrent. Catheter-directed thrombolysis (CDT) may be a preferable strategy, as it has been shown to have a lower risk of bleeding than systemic thrombolysis...
October 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28571513/a-pulmonary-embolism-response-team-initial-experiences-and-future-directions
#20
REVIEW
Emily K Zern, Michael N Young, Kenneth Rosenfield, Christopher Kabrhel
Acute pulmonary embolism (PE) is a common cardiovascular condition resulting in significant morbidity and mortality. Consensus recommendations suggest risk stratification of patients into three main categories: high-risk or 'massive' PE, intermediate-risk or 'submassive' PE, and low-risk PE. Given the relative dearth of prospective, randomized clinical trials delineating optimal selection of the diverse medical, interventional, and surgical treatment approaches, clinical care requires a multidisciplinary expert approach to patients with PE...
June 2017: Expert Review of Cardiovascular Therapy
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