Related Experiment Video
Updated: Jul 23, 2025
07:44
A Porcine Model of Acute Autologous Pulmonary Embolism
Published on: September 6, 2024
454
High-Risk Pulmonary Embolism: Management for the Intensivist
Akhil Khosla1, Yiyu Zhao2, Hamid Mojibian3
1Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, Yale New Haven Hospital, New Haven, CT, USA.
Journal of Intensive Care Medicine
|July 17, 2023
Summary
High-risk pulmonary embolism (PE) is a serious condition with increasing incidence and poor outcomes. Intensivists need a comprehensive understanding of PE management to improve patient survival.
Area of Science:
- Critical Care Medicine
- Cardiology
- Pulmonology
Background:
- High-risk pulmonary embolism (PE), or massive PE, is associated with significant morbidity and mortality.
- The incidence of high-risk PE is rising, yet patient outcomes remain suboptimal.
- Critically ill patients with high-risk PE require specialized intensivist management due to complex physiology.
Purpose of the Study:
- To provide an intensivist's perspective on the physiological consequences, risk stratification, and treatment of high-risk PE.
- To review current and evolving treatment options for high-risk PE, including reperfusion and supportive care.
- To propose an algorithm for the risk stratification and acute management of high-risk PE.
Main Methods:
- Review of current literature on high-risk PE physiology, risk stratification, and management.
- Analysis of evolving treatment strategies, including reperfusion therapies.
- Development of a risk stratification and management algorithm for intensivists.
Main Results:
- High-risk PE presents significant physiological challenges requiring intensive care.
- Effective risk stratification is crucial for guiding appropriate treatment.
- Multiple evolving treatment options exist, necessitating a structured approach to care.
Conclusions:
- A comprehensive understanding of high-risk PE is essential for intensivists to improve patient outcomes.
- Risk stratification and timely, tailored interventions are key to managing high-risk PE.
- The proposed algorithm offers a framework for intensivist-led acute management of high-risk PE.
More Related Videos
07:57Establishment of a Minimally Invasive Rat Model of Pulmonary Embolism Using Autologous Blood Clots
Published on: October 25, 2024
364
07:41Induction and Phenotyping of Acute Right Heart Failure in a Large Animal Model of Chronic Thromboembolic Pulmonary Hypertension
Published on: March 17, 2022
3.0K
Related Concept Videos
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
12
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...
12
01:27Pulmonary Embolism III: Nursing Management
15
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...
15
01:29Pulmonary Embolism I: Introduction
8
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...
8
01:29Venous Thrombosis III: Interprofessional Care
10
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
10
01:30Venous Thrombosis IV: Nursing Management
14
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
14
01:28Acute Coronary Syndrome IV: Interprofessional Care
12
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
12