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Related Concept Videos

Pulmonary Embolism I: Introduction01:29

Pulmonary Embolism I: Introduction

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 I: Introduction01:19

Pulmonary Embolism I: Introduction

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...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

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...
Pulmonary Embolism III: Nursing Management01:27

Pulmonary Embolism III: Nursing Management

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...
Pneumothorax II: Pathophysiology01:08

Pneumothorax II: Pathophysiology

Pneumothorax means the presence of air in the pleural space — the thin potential gap between the visceral and parietal pleura. This condition disrupts the normal pressure balance that keeps the lungs inflated, leading to partial or complete collapse of the affected lung.Normal physiologyUnder normal conditions, the pleural space maintains a slightly negative intrapleural pressure, which keeps the lungs expanded against the chest wall. This negative pressure creates a delicate balance between...
Pulmonary Edema II: Pathophysiology01:18

Pulmonary Edema II: Pathophysiology

Pulmonary edema is the accumulation of fluid in the interstitial and alveolar spaces of the lungs, impairing gas exchange and oxygen delivery. It may be cardiogenic or noncardiogenic, but both reduce oxygenation and lung compliance.Cardiogenic Pulmonary EdemaCardiogenic edema results from increased hydrostatic pressure in pulmonary capillaries, usually due to left ventricular dysfunction from myocardial infarction, heart failure, or valvular disease. Ineffective cardiac pumping causes blood to...

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A Porcine Model of Acute Autologous Pulmonary Embolism
07:44

A Porcine Model of Acute Autologous Pulmonary Embolism

Published on: September 6, 2024

Pulmonary embolism: the weekend effect.

Rahul Nanchal1, Gagan Kumar1, Amit Taneja1

  • 1Division of Pulmonary and Critical Care Medicine, Milwaukee, WI.

Chest
|March 31, 2012
PubMed
Summary
This summary is machine-generated.

Weekend admissions for pulmonary embolism (PE) increase mortality risk by 20%. Delays in diagnosis and treatment, particularly inferior vena cava (IVC) filter placement, contribute to worse outcomes for weekend PE patients.

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Area of Science:

  • Cardiology
  • Pulmonary Medicine
  • Health Services Research

Background:

  • Pulmonary embolism (PE) is a critical, life-threatening condition requiring prompt medical attention.
  • Previous research indicates poorer outcomes for weekend admissions across various time-sensitive conditions.
  • The impact of weekend admissions on PE outcomes remains under-investigated.

Purpose of the Study:

  • To determine if weekend admissions for pulmonary embolism are associated with higher in-hospital mortality.
  • To explore potential reasons for mortality differences, focusing on the timing of interventions like IVC filter placement and thrombolytic therapy.

Main Methods:

  • Analysis of the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (2000-2008).
  • Comparison of all-cause in-hospital mortality between weekend and weekday PE admissions.
  • Investigation into the timing of inferior vena cava (IVC) filter placement and thrombolytic infusion.

Main Results:

  • Weekend PE admissions showed significantly higher unadjusted and adjusted in-hospital mortality rates (OR 1.17; 95% CI 1.11-1.22).
  • Patients admitted on weekdays were more likely to receive an IVC filter on their first hospital day compared to weekend admissions (38% vs 29%, P < .001).
  • No significant difference was observed in the timing of thrombolytic therapy between weekend and weekday admissions.

Conclusions:

  • Weekend admissions for pulmonary embolism are linked to increased mortality.
  • Delayed IVC filter placement for weekend admissions suggests potential disparities in diagnostic and treatment timeliness.
  • Physicians must recognize the elevated 20% mortality risk for weekend PE admissions and ensure vigilant care.