Management of Shock in Patients With Pulmonary Embolism-Management of Shock in Patients with PE, Dr. Allison Dupont

Management of Shock in Patients with PE, Dr. Allison Dupont

Video Transcription

Video Summary

The presentation discusses managing shock in pulmonary embolism (PE) patients, highlighting identification of normotensive shock and elevated lactate as key risk indicators. A case of a 78-year-old male with massive PE and clot in transit was managed successfully with awake veno-arterial ECMO and catheter embolectomy, leading to rapid hemodynamic improvement and discharge by day four. Data suggest many intermediate-risk PE patients have normotensive shock, and lactate levels correlate with mortality. Mechanical circulatory support like VA ECMO may benefit select patients, especially combined with reperfusion, but its standalone survival benefit is unclear. Early intervention and careful patient staging are advised.

Keywords

pulmonary embolism

normotensive shock

lactate levels

veno-arterial ECMO

catheter embolectomy