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Related Concept Videos

Pneumothorax-I01:26

Pneumothorax-I

A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
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Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Pulmonary Embolism I: Introduction01:29

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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
Pulmonary Embolism I: Introduction01:19

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A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...

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Correction: Ficany et al. Epistaxis Prevention, Treatment, and Future Perspectives for Hereditary Hemorrhagic Telangiectasia. <i>J. Clin. Med.</i> 2025, <i>14</i>, 7724.

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Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet
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Massive pulmonary embolism.

Nils Kucher1, Elisa Rossi, Marisa De Rosa

  • 1Cardiovascular Division, Department of Medicine, University Hospital Zurich, Zurich, Switzerland.

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Massive pulmonary embolism (PE) treatment outcomes show thrombolysis did not improve survival, while inferior vena cava (IVC) filters may reduce mortality. Further research is needed for IVC filter efficacy in massive PE patients.

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Area of Science:

  • Cardiology
  • Pulmonary Medicine
  • Critical Care Medicine

Background:

  • Acute massive pulmonary embolism (PE) is associated with a high mortality rate.
  • Adjunctive therapies like thrombolysis and inferior vena cava (IVC) filters are used in massive PE management.
  • Understanding the impact of these therapies on clinical outcomes is crucial.

Purpose of the Study:

  • To investigate the utilization of thrombolysis and IVC filter placement in patients with massive PE.
  • To assess the effect of these adjunctive therapies on the clinical outcomes of massive PE patients.

Main Methods:

  • Analysis of data from the International Cooperative Pulmonary Embolism Registry (ICOPER).
  • Inclusion of 2392 patients with acute PE, identifying 108 (4.5%) with massive PE (systolic arterial pressure <90 mm Hg).
  • Comparison of outcomes between patients receiving thrombolysis, embolectomy, or IVC filters versus those who did not.

Main Results:

  • Massive PE patients had a 90-day mortality rate of 52.4% compared to 14.7% for non-massive PE patients.
  • Thrombolytic therapy did not significantly reduce 90-day mortality (46.3% vs. 55.1%) or recurrent PE rates (12% vs. 12%).
  • Inferior vena cava (IVC) filter placement was associated with a reduction in 90-day mortality (hazard ratio, 0.12) and no recurrent PE events.

Conclusions:

  • Two-thirds of massive PE patients in ICOPER did not receive thrombolysis or embolectomy.
  • Thrombolysis did not demonstrate a mortality benefit or reduction in recurrent PE at 90 days.
  • The potential mortality reduction associated with IVC filters warrants further investigation.