What’s new in severe pulmonary embolism?
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Severe pulmonary embolism (PE) remains a major cause of mortality. For intensivists managing the most “severe” forms of PE, we highlight the main recent advances in the care of such patients including risk stratification, diagnostic algorithms, general supportive care, and reperfusion therapy.
Quickly identify patients presenting with severe PE but also patients with intermediate-high-risk PE
Severe or high-risk PE is defined by cardiac arrest, or persistent hypotension (i.e., systolic blood pressure < 90 mmHg or a systolic pressure drop by 40 mmHg, for > 15 min, if not caused by new onset arrhythmia, hypovolemia, or sepsis) accompanied by signs of end-organ hypoperfusion [1, 2, 3]. High-risk PE represents less than 5% of all acute PE and constitutes a medical emergency, associated with a 15–50% risk of in-hospital death, particularly during the first hours after admission [1, 2, 3]. Among initially hemodynamically stable patients, about 10% may suffer early clinical and...
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