Pulmonary Embolism [Working Title]最新文献

Anticoagulants in the Management of Pulmonary Embolism 抗凝剂在肺栓塞治疗中的应用

Pulmonary Embolism [Working Title] Pub Date : 2021-11-14 DOI: 10.5772/intechopen.100471

Ladan Panahi, G. Udeani, Michael A. Horseman, J. Weston, Nephy G Samuel, Merlyn Joseph, Andrea Mora, Daniela Z Bazan, Pooja Patel

{"title":"Anticoagulants in the Management of Pulmonary Embolism","authors":"Ladan Panahi, G. Udeani, Michael A. Horseman, J. Weston, Nephy G Samuel, Merlyn Joseph, Andrea Mora, Daniela Z Bazan, Pooja Patel","doi":"10.5772/intechopen.100471","DOIUrl":"https://doi.org/10.5772/intechopen.100471","url":null,"abstract":"Pulmonary embolism management has typically been accomplished with anticoagulant treatment that includes parenteral heparins and oral vitamin K antagonists. Even though heparins and oral vitamin K antagonists continue to play a role in pulmonary embolism management, other newer available options have somewhat reduced the role of heparins and vitamin K antagonists in pulmonary embolism management. This reduction in utilization involves their toxicity profile, clearance limitations, and many drug and nutrient interactions. New direct oral anticoagulation therapies have led to more available options in the management of pulmonary embolism in the inpatient and outpatient settings. More evidence and research are now available about reversal agents and monitoring parameters regarding these newer agents, leading to more interest in administering them for safe and effective pulmonary embolism management. Current research and literature have also helped direct the selection of appropriate use of pharmacological management of pulmonary embolism based on the specific population such as patients with liver failure, renal failure, malignancy, and COVID-19.","PeriodicalId":112654,"journal":{"name":"Pulmonary Embolism [Working Title]","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121731949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Diagnosis of Pulmonary Embolism 肺栓塞的诊断

Pulmonary Embolism [Working Title] Pub Date : 2021-11-07 DOI: 10.5772/intechopen.101047

Sachin M. Patil

{"title":"Diagnosis of Pulmonary Embolism","authors":"Sachin M. Patil","doi":"10.5772/intechopen.101047","DOIUrl":"https://doi.org/10.5772/intechopen.101047","url":null,"abstract":"Pulmonary embolism is an acute emergency due to the occlusion of the pulmonary arteries by a venous blood clot. The pathophysiology of pulmonary embolism follows Virchow's triad, which encompasses stasis in veins, increased coagulation, and vessel wall trauma. Pregnancy, major trauma or surgery, prolonged immobilization, obesity, medication, and inherited risks are important risks. It is an essential rule-out diagnosis in chest pain and dyspnea patients in the emergency room. It is also responsible for significant mortality if not diagnosed and treated promptly. Physicians utilize multiple algorithmic scores and calculators to supplement diagnosis along with a high degree of clinical suspicion at initial presentation. Clinical diagnosis involves utilizing multiple modalities, including D-dimer, troponin, arterial blood gas analysis, electrocardiogram, bedside echocardiogram, and imaging modalities such as venous duplex, chest computed tomography, ventilation-perfusion scans, and pulmonary angiogram. Some imaging modalities carry the risk of radiation and being invasive. The treatment can itself be short-term or lifelong based on the causative factor. Anticoagulants used in the therapy can itself cause devastating complications if not monitored appropriately. Despite adequate treatment, some of these patients progress to chronic disease resulting in secondary pulmonary hypertension.","PeriodicalId":112654,"journal":{"name":"Pulmonary Embolism [Working Title]","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114438413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Thrombolytic Therapy in Pulmonary Thromboembolism 肺血栓栓塞的溶栓治疗

Pulmonary Embolism [Working Title] Pub Date : 2021-10-11 DOI: 10.5772/intechopen.100600

Navdeep Singh Sidhu, S. Kaur

引用次数: 0

Pulmonary Embolism in COVID-19 Patients: Facts and Figures COVID-19患者的肺栓塞:事实和数据

Pulmonary Embolism [Working Title] Pub Date : 2021-09-13 DOI: 10.5772/intechopen.99942

Nissar Shaikh, Narges Quyyum, Arshad H. Chanda, M. Zubair, Muhsen Shaheen, Shajahan Idayatulla, S. Aboobacker, Jazib Hassan, Shoaib Nawaz, Ashish Kumar, M. M. Nainthramveetil, Zubair Shahid, Ibrahim Rasheed

{"title":"Pulmonary Embolism in COVID-19 Patients: Facts and Figures","authors":"Nissar Shaikh, Narges Quyyum, Arshad H. Chanda, M. Zubair, Muhsen Shaheen, Shajahan Idayatulla, S. Aboobacker, Jazib Hassan, Shoaib Nawaz, Ashish Kumar, M. M. Nainthramveetil, Zubair Shahid, Ibrahim Rasheed","doi":"10.5772/intechopen.99942","DOIUrl":"https://doi.org/10.5772/intechopen.99942","url":null,"abstract":"COVID-19 infection affects many systems in the body including the coagulation mechanisms. Imbalance between pro-coagulant and anticoagulant activities causes a roughly nine times higher risk for pulmonary embolism (PE) in COVID-19 patients. The reported incidence of PE in COVID-19 patients ranges from 3 to 26%. There is an increased risk of PE in hospitalized patients with lower mobility and patients requiring intensive care therapy. Obesity, atrial fibrillation, raised pro-inflammatory markers, and convalescent plasma therapy increases the risk of PE in COVID-19 patients. Endothelial injury in COVID-19 patients causes loss of vasodilatory, anti-adhesion and fibrinolytic properties. Viral penetration and load leads to the release of cytokines and von Willebrand factor, which induces thrombosis in small and medium vessels. D-dimers elevation gives strong suspicion of PE in COVID-19 patients, and normal D-dimer levels effectively rule it out. Point of care echocardiogram may show right heart dilatation, thrombus in heart or pulmonary arteries. DVT increases the risk of developing PE. The gold standard test for the diagnosis of PE is CTPA (computerized tomographic pulmonary angiography) which also gives alternative diagnosis in the absence of PE. Therapeutic anticoagulation is the corner stone in the management of PE and commonly used anticoagulants are LMWH (low molecular weight heparin) and UFH (unfractionated heparin). Mortality in COVID-19 patients with PE is up to 43% compared to COVID patients without PE being around 3%.","PeriodicalId":112654,"journal":{"name":"Pulmonary Embolism [Working Title]","volume":"135 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114160155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0