Acute pulmonary embolism. Aggressive therapy with anticoagulants and thrombolytics.

摘要: Patients with acute pulmonary embolism are at risk for early death or chronic morbidity. Appropriate therapy can dramatically reduce the incidence of both. Oxygen and heparin should be started as soon diagnosis is suspected. The condition a hypotensive patient right ventricular overload from usually made worse by fluid challenge; hypotension may relieved preload reduction even gentle diuresis. Norepinephrine (Levophed), isoproterenol hydrochloride (Isuprel), epinephrine pressor agents choice. Immediate thrombolysis standard care any significant hypoxemia due to proven embolism. Beyond this, potential benefit using thrombolytic considered routinely every Surgical embolectomy useful unstable when there absolute contraindications fails. Empirical use last-ditch effort critically ill high clinical suspicion Standard closed-chest cardiopulmonary resuscitation ineffective circulation obstructed thrombus. Emergency thoracotomy femorofemoral bypass appropriately used in patients full cardiac arrest