Management of Shock in Patients With Pulmonary Embolism-Panel Discussion

Video Transcription

Video Summary

The panel discussed pulmonary embolism management, emphasizing always measuring pulmonary artery pressures before interventions. High pressures alone don't exclude thrombectomy unless chronic clot is evident on CT. CT scans help detect chronic clots, but they can be subtle; history and VQ scans aid diagnosis. For hospital transfers, protocols now discourage knee-jerk thrombolytics; instead, stabilize, consult, and decide collectively. Low-dose thrombolytics show promise but need further study. IVC filters are reserved mainly for anticoagulation contraindications. Managing patients on VA ECMO requires careful coordination to avoid air embolism during thrombectomy. Surgical embolectomy is rare with advancing catheter-based options.

Keywords

pulmonary embolism

pulmonary artery pressure

thrombectomy

CT scan

thrombolytics