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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...
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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...
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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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Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
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Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
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Emphysema, a major phenotype of chronic obstructive pulmonary disease (COPD), is characterized by irreversible destruction of alveolar walls and permanent enlargement of distal airspaces. Unlike chronic bronchitis, which primarily affects the airways, emphysema predominantly involves the lung parenchyma, where structural damage leads to airflow limitation.PathophysiologyIt most commonly results from prolonged exposure to cigarette smoke and other toxic gases, particularly cigarette smoke.
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Mortality in Pulmonary Embolism According to Risk Category at Presentation in Emergency Department: Impact of Cardiac Arrest.

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Pulmonary embolectomy in elderly patients.

Paul D Stein1, Fadi Matta2

  • 1Department of Osteopathic Medical Specialties, Michigan State University College of Osteopathic Medicine, East Lansing, Mich.

The American Journal of Medicine
|December 17, 2013
PubMed
Summary

Pulmonary embolectomy case fatality increases with age in stable patients over 50. Age does not impact outcomes for unstable patients undergoing this procedure.

Keywords:
Pulmonary embolectomyPulmonary embolismVenous thromboembolism

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Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Health Services Research

Background:

  • Pulmonary embolism (PE) is a significant cause of mortality.
  • Pulmonary embolectomy is a treatment option for PE.
  • The impact of patient age on outcomes after pulmonary embolectomy is not well-established.

Purpose of the Study:

  • To investigate the relationship between age and case fatality rate in patients undergoing pulmonary embolectomy.
  • To determine if age influences the risk of in-hospital mortality following pulmonary embolectomy.

Main Methods:

  • Analysis of the Nationwide Inpatient Sample database (1999-2008).
  • Identification of patients who underwent pulmonary embolectomy for pulmonary embolism.
  • Assessment of in-hospital all-cause case fatality rate stratified by age groups.

Main Results:

  • The proportion of patients undergoing pulmonary embolectomy decreased with increasing age.
  • In stable patients, case fatality rate increased significantly with age, rising from 17.4% in those aged 51-60 to 46.2% in those over 80.
  • Age did not correlate with case fatality rate in unstable patients.

Conclusions:

  • Pulmonary embolectomy in stable patients is associated with an increased risk of death in older individuals (over 51-60 years).
  • Age does not appear to be a significant factor in the case fatality rate for unstable patients undergoing pulmonary embolectomy.