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management of pulmonary embolism

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https://www.readbyqxmd.com/read/29672125/submassive-pulmonary-embolism
#1
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
#2
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/29666716/survival-after-cardiac-arrest-secondary-to-massive-pulmonary-embolism
#3
Abdullah E Laher, Muhammed Moolla, Feroza Motara, Fathima Paruk, Guy Richards
Introduction: It is estimated that the diagnosis of pulmonary embolism (PE) is missed in as many as 84% of all cases of PE. Cardiac arrest following PE is generally associated with poor outcomes. Case Report: A 43-year-old man presented to the Emergency Department (ED) in cardiac arrest. Swelling of his right lower limb was noted on arrival. Point of care ultrasound was performed during ongoing cardiopulmonary resuscitation (CPR) and showed a thrombus in the right iliofemoral vein as well as dilatation of the right ventricle...
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29661366/a-systematic-review-of-venous-aneurysms-by-anatomic-location
#4
REVIEW
Katherine A Teter, Thomas M Maldonado, Mark A Adelman
OBJECTIVE: Venous aneurysms are uncommon vascular abnormalities that may be identified anywhere in the body. Historically, they were often misdiagnosed as soft tissue lesions, but with the advent of readily available noninvasive imaging (such as duplex ultrasound), they can now be easily identified. Our aim was to review the presentation of venous aneurysms, available imaging modalities for defining them, and management. METHODS: The English-language literature before March 2017 was reviewed, and only reports of primary venous aneurysms of the deep veins were included...
May 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29652041/-alternating-pneumocompression-effective-physiotherapeutic-method-for-the-prevention-of-venous-thromboembolic-complications-in-patients-of-medium-and-high-risk-in-the-acute-period-of-the-stroke
#5
I Y Galyaev
BACKGROUND: the patients presenting with severe post-stroke in the acute period of this condition are characterized by the high risk of venous thromboembolic complications (VTEC), with the most dangerous of them being pulmonary embolism that makes an appreciable contribution to the mortality rate of such patients at the hospital stage of their treatment. Among the physical methods for the prevention of VTE, such as wearing graduated compression stockings (GCS), myoelectrostimulation (MES), pneumatic intermittent compression (PIC), only the latter technique has been shown to be efficient when applied for the treatment of surgical patients during the post-stroke period with the level of evidence 2B and the very uncertain parameters of the impact...
April 9, 2018: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
https://www.readbyqxmd.com/read/29650544/evaluation-and-management-of-right-sided-heart-failure-a-scientific-statement-from-the-american-heart-association
#6
REVIEW
Marvin A Konstam, Michael S Kiernan, Daniel Bernstein, Biykem Bozkurt, Miriam Jacob, Navin K Kapur, Robb D Kociol, Eldrin F Lewis, Mandeep R Mehra, Francis D Pagani, Amish N Raval, Carey Ward
BACKGROUND AND PURPOSE: The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality...
April 12, 2018: Circulation
https://www.readbyqxmd.com/read/29645405/outcomes-following-a-negative-computed-tomography-pulmonary-angiography-according-to-pulmonary-embolism-prevalence-a-meta-analysis-of-the-management-outcome-studies
#7
D Belzile, S Jacquet, L Bertoletti, Y Lacasse, C Lambert, J C Lega, S Provencher
BACKGROUND: Outcomes studies have reported the safety of computed tomographic pulmonary angiography (CTPA) as a stand-alone imaging to rule out pulmonary embolism (PE). Whether this can be applied to all clinical probabilities remains controversial. OBJECTIVES: We performed a meta-analysis to determine the proportion of patients with venous thromboembolic events (VTE) despite a negative CTPA according to pretest PE prevalence. METHODS: We searched MEDLINE, EMBASE and the Cochrane Library (1/1990 to 5/2017) for outcomes studies recruiting patients with suspected PE using CTPA as a diagnostic strategy...
April 12, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29644546/imaging-of-urgencies-and-emergencies-in-the-lung-cancer-patient
#8
REVIEW
Bruno De Potter, Jef Huyskens, Birgitta Hiddinga, Maarten Spinhoven, Annelies Janssens, Jan P van Meerbeeck, Paul M Parizel, Annemie Snoeckx
Lung cancer patients often experience potentially life-threatening medical urgencies and emergencies, which may be a direct or indirect result of the underlying malignancy. This pictorial review addresses the most common thoracic, neurological and musculoskeletal medical emergencies in lung cancer patients, including superior vena cava syndrome, pulmonary embolism, spontaneous pneumothorax, cardiac tamponade, massive haemoptysis, central airway obstruction, oesophagorespiratory fistula, malignant spinal cord compression, carcinomatous meningitis, cerebral herniation and pathological fracture...
April 11, 2018: Insights Into Imaging
https://www.readbyqxmd.com/read/29628339/ischemic-stroke-secondary-to-paradoxical-embolism-through-a-pulmonary-arteriovenous-malformation-case-report-and-review-of-the-literature
#9
Ryan Cappa, Jeanette Du, Joseph F Carrera, Jimmy V Berthaud, Andrew M Southerland
Paradoxical embolism due to isolated pulmonary arteriovenous malformation (AVM) is an uncommon cause of ischemic stroke, with the majority occurring in patients who have not yet been diagnosed with their malformation. We report a 32-year-old man who presented with an abrupt onset of right facial weakness and expressive aphasia. Brain magnetic resonance imaging revealed an acute infarct in the left middle cerebral artery territory and chronic infarcts in the bilateral cerebellar hemispheres. A cardioembolic mechanism was initially considered in the setting of perimyocarditis diagnosed a few months earlier...
April 5, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29622996/clinical-profile-management-and-outcome-of-pulmonary-embolism-in-shahid-gangalal-national-heart-centre-kathmandu-nepal
#10
Chandra Mani Adhikari, K C Bishal, Sobita Khadka
Background and aims: Pulmonary embolism (PE) is associated with a significant mortality and morbidity. We aim to study clinical profile, management and outcome of PE at Shahid Gangalal National heart Centre, Kathmandu, Nepal. Methods: It was a retrprospective, single centre study, conducted from January 2015 to December 2016. Haemodynamics was used for risk Simplified, PESI score, predisposing factors, symptoms, clinical features at the time of admission, ECG features, echocardiogram, treatment received and the outcome were reviewed...
March 2018: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
https://www.readbyqxmd.com/read/29619261/septic-pulmonary-emboli-and-renal-abscess-caused-by-staphylococcus-aureus-in-an-hiv-infected-patient
#11
Isaí Medina-Piñón, Alan Ledif Reyes-Mondragón, Michel Fernando Martínez-Reséndez, Adrián Camacho-Ortiz
Staphylococcus aureus is a common cause of bacteremia in the general population and can lead to serious metastatic infection particularly in immunocompromised persons. However, prompt diagnosis and management can result in favorable outcomes. In the following case report, the clinical course of an HIV-infected man is presented; he developed bloodstream infection (BSI) and associated complications: septic pulmonary embolism, right renal abscess, and ipsilateral renal vein thrombosis. Methicillin-resistant Staphylococcus aureus (MRSA) was identified as the cause of sepsis and successfully treated with surgery and antimicrobials...
2018: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29616915/refractory-hypoxemia-in-a-patient-with-submassive-pulmonary-embolism-and-an-intracardiac-shunt-a-case-report-and-review-of-the-literature
#12
REVIEW
Jean Liew, Janelle Stevens, Christopher Slatore
INTRODUCTION: Acute pulmonary embolism is the third leading cause of cardiovascular death. Management options include anticoagulation with or without thrombolysis. Concurrent persistent hypoxemia should be a clue to the existence of an intracardiac shunt. CASE PRESENTATION: A 46-year-old man experienced acute hypoxemic respiratory failure requiring mechanical ventilation after anesthesia induction for elective hip arthroplasty. He was found to have submassive bilateral pulmonary emboli with acute right ventricular dysfunction and a coexisting patent foramen ovale with right-to-left shunt...
March 2, 2018: Permanente Journal
https://www.readbyqxmd.com/read/29613956/optimal-timing-of-initiation-of-thromboprophylaxis-in-spine-trauma-managed-operatively-a-nationwide-propensity-matched-analysis-of-trauma-quality-improvement-program
#13
Muhammad Zeeshan, Muhammad Khan, Terence O'Keeffe, Nina Pollack, Mohammad Hamidi, Narong Kulvatunyou, Joseph V Sakran, Lynn Gries, Bellal Joseph
INTRODUCTION: Patients with spinal trauma are at high-risk for venous-thromboembolism(VTE). Guidelines recommend prophylactic anticoagulation but they are unclear on timing of initiation of thromboprophylaxis. The aim of our study was to assess the impact of early vs late initiation of venous thromboprophylaxis in patients with spinal trauma who underwent operative intervention. METHODS: We performed a 2-year (2013-14) review of patients with isolated spine trauma (S-AIS≥3 and no other injury in another body region with AIS>2) who underwent operative intervention and received thromboprophylaxis post-operatively...
April 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29602488/femoral-arterial-and-central-venous-catheters-in-the-trauma-resuscitation-room
#14
S R Hamada, M Fromentin, M Ronot, T Gauss, A Harrois, J Duranteau, C Paugam-Burtz
BACKGROUND: Arterial and central venous femoral catheters (fAC-CVC) use during the initial management of severe trauma patients is not a standard technique in most trauma centers. Arguments in favor of their use are: continuous monitoring of blood pressure, safe drug administration, easy blood sampling and potentially large bore venous access. The lack of evidence makes the practice heterogeneous. The aim of the present study was to describe the use and complications of fAC-CVC in the trauma bay in two centers where they are routinely used...
March 23, 2018: Injury
https://www.readbyqxmd.com/read/29600543/speckle-tracking-analysis-in-intensive-care-unit-a-toy-or-a-tool
#15
REVIEW
Antonello D'Andrea, Juri Radmilovic, Donato Mele, Flavio D'Ascenzi, Eustachio Agricola, Andreina Carbone, Francesco Lo Iudice, Giuseppina Novo, Francesco Ancona, Francesca Maria Righini, Sergio Mondillo, Eduardo Bossone, Maurizio Galderisi
The use of conventional echocardiography in the intensive care unit (ICU) is today established to assess left and right ventricular systolic function, for preload determination and procedural guidance. Next step in ICU echocardiography could be the use of novel ultrasound techniques such as strain echocardiography to assist in the management of patients with acute coronary syndrome, heart failure, or pulmonary embolism. This review has gathered the available evidence supporting the incremental value of strain in the diagnostic workup of cardiac diseases treated in ICU...
March 30, 2018: Echocardiography
https://www.readbyqxmd.com/read/29582318/clinical-mimics-an-emergency-medicine-focused-review-of-pneumonia-mimics
#16
REVIEW
Drew Alan Long, Brit Long, Alex Koyfman
Pneumonia is a common cause of morbidity and mortality in adults in the United States. While pneumonia classically presents with a fever, cough, and shortness of breath, the presentation can vary widely in adults. This review evaluates history and physical examination findings of pneumonia and several conditions that mimic pneumonia. Pneumonia is a potentially deadly disease. History and examination findings are variable in pneumonia, and many conditions mimic pneumonia. These conditions include pulmonary embolism, diffuse interstitial lung disease, endocarditis, vasculitis, diffuse alveolar hemorrhage, acute decompensated heart failure, tuberculosis, lung cancer, and acute respiratory distress syndrome...
March 26, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29572436/pulmonary-artery-rupture-management-with-a-single-lumen-endotracheal-tube-old-tricks-that-should-be-revisited
#17
Thanuja Neerukonda, William J Gibson, Travis Abicht, Andrew Sauer, Brigid C Flynn
BACKGROUND Pulmonary artery rupture can be a lethal complication of a pulmonary artery catheter (PAC). Different techniques have been used to manage PAC-induced pulmonary artery rupture, including double lumen endotracheal tube (DLT), bronchial blockers, pulmonary artery embolization, thoracotomy with hematoma evacuation, and extracorporeal life support for ventilation (ECLS). Single lumen endotracheal tube (ETT) is not frequently reported in the literature despite its advantages. CASE REPORT The authors present a case of PAC-induced pulmonary artery rupture successfully managed with a single lumen ETT...
March 24, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29572099/a-ten-year-analysis-of-the-reasons-for-death-following-ambulatory-surgery-nine-closed-claims-declared-to-sham-insurance
#18
A Theissen, F Fuz, M Bouregba, M Autran, M Beaussier
INTRODUCTION: The constant development of ambulatory surgery (AS) raises the problem of monitoring patients after discharge and the risk of death in the case of delays in the management of a serious complication. PATIENTS AND METHODS: The aim of this retrospective study was to describe the deaths observed within the 30-day period following AS declared to the SHAM insurance (Société Hospitalière d'Assurance Mutuelle) over the last 10 years. RESULTS: During the study period 33,962 claims were surgery-related and 11 were for deaths after AS...
March 20, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29570366/therapeutic-approach-for-patients-with-venous-thromboembolism-attended-in-emergency-departments-during-routine-clinical-practice-the-edith-study
#19
Pedro Ruiz-Artacho, Pascual Piñera, Albert Antolin, José Ramón Casal, Marta Sanchez, Coral Suero, Marta Merlo, Jorge Carriel, Mar Genis, Sonia Jimenez
AIM: To analyze treatment at discharge/follow-up of patients diagnosed with venous thromboembolism (VTE) in the emergency department (ED). MATERIALS & METHODS: Ambispective study (50 Spanish centers) of consecutive patients (October-December 2014) with VTE diagnosed in ED. RESULTS: VTE was diagnosed in 775 patients (295 pulmonary embolism [PE] without deep vein thrombosis [DVT], 389 DVT without PE and 91 PE + DVT); 95.5% received anticoagulants (90...
April 2018: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29567385/-a-structured-case-analysis-from-the-critical-incident-reporting-system-of-the-german-medical-association-and-the-national-association-of-statutory-health-insurance-physicians
#20
Thomas Schrader, Laura Tetzlaff, Katharina Löwe, Cornelia Schröder, Eberhard Beck
BACKGROUND: Reporting systems for near misses are necessary to improve patient safety. In Germany, different systems are publicly available on both a national and regional level or as systems related to various medical domains. In contrast with the British Registry, our reporting systems still lack systematic evaluation. Using the Open-Task-Process Model (OPT model) one case of CIRSmedical (www.cirsmedical.de) was selected for a systematic analysis. METHOD: Case 148384 reports on a patient with a tentative diagnosis of pulmonary embolism with an oxygen saturation of 71 %...
March 19, 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
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