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Update in the diagnosis and management of acute pulmonary embolism for the non-respiratory physician.

ABSTRACT: An increasingly common scenario on the acute medical take is that of 'possible pulmonary embolism'. The aim of this article is to update the reader about the available clinical decision tools that can help to avoid the over investigation of such patients, as well as other tools that can support an outpatient management strategy in appropriate patient groups. The importance of risk stratification methodologies in acute pulmonary embolism management is emphasised. We address the evidence on the long-term risk of venous thromboembolism recurrence and show how this can be used to make decisions about duration of anticoagulation. Finally, we discuss a number of special scenarios, including the implications of incidentally discovered isolated subsegmental pulmonary embolus and the management of pulmonary embolus in malignancy and pregnancy.

SUBMITTER: Ramjug S

PROVIDER: S-EPMC8806288 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Update in the diagnosis and management of acute pulmonary embolism for the non-respiratory physician.

Ramjug Sheila S Phillips Gerrard G

Clinical medicine (London, England) 20211101 6

An increasingly common scenario on the acute medical take is that of 'possible pulmonary embolism'. The aim of this article is to update the reader about the available clinical decision tools that can help to avoid the over investigation of such patients, as well as other tools that can support an outpatient management strategy in appropriate patient groups. The importance of risk stratification methodologies in acute pulmonary embolism management is emphasised. We address the evidence on the lo ...[more]

PMID: 34862218

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Project description:BackgroundThe diagnosis and treatment of pulmonary embolism have multi-modal approach based on specificity, sensitivity, availability of the machine, and associated risks of imaging modalities.AimThis review aimed to provide shreds of evidence that improve perioperative diagnosis and management of suspected pulmonary embolism.MethodsThe study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline 2020. After a clear criteria has been established an electronic searching database was conducted using PubMed, Google Scholar, Cochrane library, and Cumulative Index of Nursing and Allied Health Literature (CINAHL), with Key search terms included:('pulmonary embolism' AND' anesthesia management ', 'anticoagulation' AND 'pulmonary embolism', 'thrombolysis 'AND 'pulmonary embolism', 'surgery' AND' pulmonary embolism'), were used to draw the evidence.The quality of literatures were categorized based on WHO 2011 level of evidence and degree of recommendation, in addition, the study is registered with research registry unique identifying number (UIN) of reviewregistry1318." and has high quality based on AMSTAR2 assessment criteria.ResultsA totally of 27 articles were included [guidelines (n = 3), Cochrane (=5), systemic reviews (n = 7), meta-analyses (=2), RCT (n = 4), cohort studies (n = 3), and cross-sectional study (n = 3) and illegible articles identified from searches of the electronic databases were imported into the ENDNOTE software version X7.1 and duplicates were removed.DiscussionCurrently divergent and contradictory approaches are implemented in diagnosis and management for patients suspected of pulmonary embolism.ConclusionAll perioperative patients, especially trauma victims, prostate or orthopedic surgery, malignancy, immobility, and obesity; smokers; and oral contraceptive users, antipsychotic medications are at increased risk of venous thromboembolism and need special caution during surgery and anesthesia.

Dataset Information

Update in the diagnosis and management of acute pulmonary embolism for the non-respiratory physician.

Publications

Update in the diagnosis and management of acute pulmonary embolism for the non-respiratory physician.

Similar Datasets

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