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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES

iSepsis – Understanding Lactate

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jueves, 21 de julio de 2016

Hemodynamically Unstable PE

CORE EM
CORE EM - By Anand Swaminathan
"Definition: A pulmonary embolism (PE) that results in hemodynamic compromise and end-organ hypoperfusion. The physical size of the PE does not differentiate a PE as massive or submassive but rather it is the patients physiologic response to the clot(s)...
Severe PE Pathophysiology (Wood 2011)
Take Home Points
  • Massive PE is defined as any PE that results in hemodynamic instability.
  • Patients with massive PE will often be too unstable for advanced diagnostic imaging (i.e. CT scan) requiring bedside diagnosis with history, physical examination and POC US
  • Systemic administration of a fibrinolytic drug is a potentially life-saving therapeutic intervention with an NNT for death of 16. However, it comes with the significant risk of intracranial hemorrhage and major bleeding (NNH = 10)"