Latest & greatest articles for pulmonary embolism

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Top results for pulmonary embolism

1. Outpatient versus inpatient treatment for acute pulmonary embolism. (PubMed)

Outpatient versus inpatient treatment for acute pulmonary embolism. Pulmonary embolism (PE) is a common life-threatening cardiovascular condition, with an incidence of 23 to 69 new cases per 100,000 people each year. For selected low-risk patients with acute PE, outpatient treatment might provide several advantages over traditional inpatient treatment, such as reduction of hospitalisations, substantial cost savings, and improvements in health-related quality of life. This is an update

2019 Cochrane

2. Rapid blood test helps exclude pulmonary embolism for low risk patients

Rapid blood test helps exclude pulmonary embolism for low risk patients Rapid blood test helps exclude pulmonary embolism for low risk patients Discover Portal Discover Portal Rapid blood test helps exclude pulmonary embolism for low risk patients Published on 25 October 2016 doi: An inexpensive blood test can help quickly rule out pulmonary embolism for low risk patients attending hospital outpatient or emergency departments, especially in people with early symptoms. This review looked (...) diagnostic imaging. Overall a change in the management pathway for suspected pulmonary embolism (PE) have potential to be cost saving and provide better care. Commissioners, will be interested in the overall pathway costs but unfortunately these were not researched here. Share your views on the research. Why was this study needed? In the UK, 47,734 cases of PE were reported between 2014 and 2015. Emergency admissions for PE increased by 30% between 2008 and 2012. A pulmonary embolism is a blockage

2019 NIHR Dissemination Centre

3. Inhaled nitric oxide to treat intermediate risk pulmonary embolism: A multicenter randomized controlled trial. (PubMed)

Inhaled nitric oxide to treat intermediate risk pulmonary embolism: A multicenter randomized controlled trial. To test the hypothesis that adjunctive inhaled NO would improve RV function and viability in acute PE.This was a randomized, placebo-controlled, double blind trial conducted at four academic hospitals. Eligible patients had acute PE without systemic arterial hypotension but had RV dysfunction and a treatment plan of standard anticoagulation. Subjects received either oxygen plus

2019 Nitric oxide : biology and chemistry

4. Thrombolytic therapy for pulmonary embolism. (PubMed)

Thrombolytic therapy for pulmonary embolism. Thrombolytic therapy is usually reserved for patients with clinically serious or massive pulmonary embolism (PE). Evidence suggests that thrombolytic agents may dissolve blood clots more rapidly than heparin and may reduce the death rate associated with PE. However, there are still concerns about the possible risk of adverse effects of thrombolytic therapy, such as major or minor haemorrhage. This is the third update of the Cochrane review first (...) of treatment. None of the included studies reported on post-thrombotic syndrome or compared the costs of different treatments.Low-quality evidence suggests that thrombolytics reduce death following acute pulmonary embolism compared with heparin. The included studies used a variety of thrombolytic drugs. Thrombolytic therapy may be helpful in reducing the recurrence of pulmonary emboli but may cause major and minor haemorrhagic events and stroke. More high-quality, blinded randomised controlled trials

2018 Cochrane

5. Increasing Safe Outpatient Management of Emergency Department Patients With Pulmonary Embolism: A Controlled Pragmatic Trial. (PubMed)

Increasing Safe Outpatient Management of Emergency Department Patients With Pulmonary Embolism: A Controlled Pragmatic Trial. Many low-risk patients with acute pulmonary embolism (PE) in the emergency department (ED) are eligible for outpatient care but are hospitalized nonetheless. One impediment to home discharge is the difficulty of identifying which patients can safely forgo hospitalization.To evaluate the effect of an integrated electronic clinical decision support system (CDSS

2018 Annals of Internal Medicine

6. Can Echocardiography Be Used to Diagnose Pulmonary Embolism at the Bedside?

Can Echocardiography Be Used to Diagnose Pulmonary Embolism at the Bedside? TAKE-HOME MESSAGE When pretest probability for pulmonary embolism is high, abnormalities in right ventricular function detected on echocardiogram strongly support the diagnosis; however, a normal echocardiogram cannot be used to rule out pulmonary embolism. Can Echocardiography Be Used to Diagnose Pulmonary Embolism at the Bedside? EBEM Commentators Robert R. Ehrman, MD Mark J. Favot, MD Department of Emergency Medicine (...) by cardiologists, and 1 unclear)andatthepointofcarein 7 studies; 7 studies were con- ducted solely in the ED. The authors identi?ed 9 unique echocardiographic signs of pulmo- nary embolism, as well as the unde?ned ?nding of “right-sided heart strain.” Overall, the signs of pulmonary embolism were moder- atelyspeci?c(range61%to99%)but poorly sensitive (range 5% to 80%). Test characteristics were slightly improved when echocardiograms were performed by physicians. In the pooled and subgroup analyses, McConnell’s

2018 Annals of Emergency Medicine Systematic Review Snapshots

7. What Is the Best Imaging Study to Rule Out Pulmonary Embolism in Pregnancy? (SRS diagnosis)

What Is the Best Imaging Study to Rule Out Pulmonary Embolism in Pregnancy? (SRS diagnosis) What Is the Best Imaging Study to Rule Out Pulmonary Embolism in Pregnancy? TAKE-HOME MESSAGE Both computed tomography (CT) pulmonary angiography and lung scintigraphy (ie, ventilation-perfusion scan) are appropriate imaging options for exclusion of pulmonary embolism during pregnancy. EBEM Commentators Latha Ganti, MD, MBA David Lebowitz, MD Department of Clinical Sciences University of Central Florida (...) College of Medicine Orlando, FL Jestin N. Carlson, MD, MS, and Alan Jones, MD, serve as editors of the SRS series. Editor’s Note: This is a clinical synopsis, a regular feature of the Annals’ Systematic Review Snapshot (SRS) series. The source for this systematic review snapshot is: van Mens TE, Scheres LJJ, de Jong PG, et al. Imaging for theexclusion of pulmonary embolism in pregnancy. Cochrane Database Syst Rev. 2017;1:CD011053. Results Summary of results for the diagnosis of pulmonary embolism

2018 Annals of Emergency Medicine Systematic Review Snapshots

8. Accuracy and Interobserver Reliability of the Simplified Pulmonary Embolism Severity Index Versus the Hestia Criteria for Patients With Pulmonary Embolism

Accuracy and Interobserver Reliability of the Simplified Pulmonary Embolism Severity Index Versus the Hestia Criteria for Patients With Pulmonary Embolism The objective was to assess and compare the accuracy and interobserver reliability of the simplified Pulmonary Embolism Severity Index (sPESI) and the Hestia criteria for predicting short-term mortality in patients with pulmonary embolism (PE).This prospective cohort study evaluated consecutive eligible adults with PE diagnosed

2018 EvidenceUpdates

9. Diagnosis of Pulmonary Embolism During Pregnancy: A Multicenter Prospective Management Outcome Study. (PubMed)

Diagnosis of Pulmonary Embolism During Pregnancy: A Multicenter Prospective Management Outcome Study. Data on the optimal diagnostic management of pregnant women with suspected pulmonary embolism (PE) are limited, and guidelines provide inconsistent recommendations on use of diagnostic tests.To prospectively validate a diagnostic strategy in pregnant women with suspected PE.Multicenter, multinational, prospective diagnostic management outcome study involving pretest clinical probability (...) assessment, high-sensitivity D-dimer testing, bilateral lower limb compression ultrasonography (CUS), and computed tomography pulmonary angiography (CTPA). (ClinicalTrials.gov: NCT00740454).11 centers in France and Switzerland between August 2008 and July 2016.Pregnant women with clinically suspected PE in emergency departments.Pulmonary embolism was excluded in patients with a low or intermediate pretest clinical probability and a negative D-dimer result. All others underwent lower limb CUS

2018 Annals of Internal Medicine

10. BTS Guidelines for the outpatient management of pulmonary embolism

BTS Guidelines for the outpatient management of pulmonary embolism Thorax An international journal of RESPIRATORY MEDICINE thorax.bmj.com July 2018 Volume 73 Supplement 2 BRITISH THORACIC SOCIETY GUIDELINE FOR THE INITIAL OUTPATIENT MANAGEMENT OF PULMONARY EMBOLISM British Thoracic Society Outpatient Management of Pulmonary Embolism Guideline Development GroupHealthcare providers need to use clinical judgement, knowledge and expertise when deciding whether it is appropriate to apply (...) recommendations for the management of patients. The recommendations cited here are a guide and may not be appropriate for use in all situations. The guidance provided does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of each patient, in consultation with the patient and/or their guardian or carer.BTS Outpatient Management of Pulmonary Embolism Guideline Development Group Dr Luke Howard (Chair), Dr Steve Barden, Dr Robin Condliffe, Dr Vincent

2018 British Thoracic Society

11. Prevalence of pulmonary embolism in syncope

Prevalence of pulmonary embolism in syncope Emergency Medicine > Journal Club > Archive > March 2018 Toggle navigation March 2018 2018 Prevalence of PE in Syncope Vignette You're working a TCC shift with Dr. Cohn, sitting right beside you. He's drinking a Diet Coke, having not offered you one. You decide to go see your next patient, a 78 year old female, complaining of "feeling woozy". she endorses syncope, shortness of breath, and leg pain. She is saturating 89% on room air, tachycardic to 104 (...) , and BP 117/76. She has many other reasons other than a pulmonary embolism to be feeling this way, but the syncope has you thinking. You remember reading an article that was all the rage a few months ago regarding syncope as a presenting complaint for PE. It was fake news, you said. So vague. But here you are. You've got a minute, and Dr. Cohn by your side. You search the literature and gently fall into a rabbit hole... PICO Question Population: Adult patients presenting to the ED with syncope

2018 Washington University Emergency Medicine Journal Club

12. Safety of the Combination of PERC and YEARS Rules in Patients With Low Clinical Probability of Pulmonary Embolism: A Retrospective Analysis of Two Large European Cohorts

Safety of the Combination of PERC and YEARS Rules in Patients With Low Clinical Probability of Pulmonary Embolism: A Retrospective Analysis of Two Large European Cohorts This study aimed to determine the failure rate of a combination of the PERC and the YEARS rules for the diagnosis of pulmonary embolism (PE) in the emergency department (ED).We performed a retrospective analysis of two European cohorts of emergency patients with low gestalt clinical probability of PE (PROPER and PERCEPIC). All (...) patients we included were managed using a conventional strategy (D-dimer test, followed, if positive, by computed tomographic pulmonary angiogram (CTPA). We tested a diagnostic strategy that combined PERC and YEARS to rule out PE. The primary endpoint was a thromboembolic event diagnosed in the ED or at 3-months follow-up. Secondary endpoints included a thromboembolic event at baseline in the ED and a CTPA in the ED. Ninety-five percent confidence intervals (CIs) of proportions were calculated

2018 EvidenceUpdates

13. Blood and Clots Series: Diagnosing pulmonary embolism in pregnancy

Blood and Clots Series: Diagnosing pulmonary embolism in pregnancy Blood and Clots Series: Diagnosing pulmonary embolism in pregnancy - CanadiEM Blood and Clots Series: Diagnosing pulmonary embolism in pregnancy In , by Eric Tseng August 13, 2018 All the content from the Blood & Clots series can be found . CanMEDS Roles addressed: Medical Expert Case Description A pregnant 32 year old female presents to the ER with chest pain. She is 33 weeks gestational age, and this is her third pregnancy (...) air, and respiratory rate is 22. Her weight is 80 kg. Cardiac and respiratory examinations are unremarkable. She has no leg swelling or erythema. Her abdomen demonstrates a gravid uterus. Her bloodwork demonstrates a Hb of 98, WBC 5.0, platelets 156, creatinine 80. D-Dimer is 1,080. Her chest x-ray is unremarkable, with no effusions or consolidation. Does she have a pulmonary embolism (PE)? Main Text Question 1: How helpful are clinical prediction rules and D-Dimer for ruling in or ruling out

2018 CandiEM

14. Prediction of short-term prognosis in elderly patients with acute pulmonary embolism: validation of the RIETE score

Prediction of short-term prognosis in elderly patients with acute pulmonary embolism: validation of the RIETE score Essentials The RIETE score was derived to predict 10-day adverse outcomes in acute pulmonary embolism (PE). We externally validated the RIETE score in a prospective cohort of patients with PE. The RIETE score classified fewer patients as low-risk than currently recommended scores. The RIETE score was not superior to other scores in predicting 10-day adverse outcomes.Introduction (...) The Registro Informatizado de la Enfermedad TromboEmbolica (RIETE) score was derived to identify patients with pulmonary embolism (PE) at low risk of overall complications. Objective To externally validate the RIETE score and compare its prognostic performance with the Pulmonary Embolism Severity Index (PESI), its simplified version (sPESI) and the Geneva Prognostic Score (GPS). Methods In a prospective multicenter cohort, we studied 687 elderly patients with acute PE. The primary outcome was 10-day

2018 EvidenceUpdates

15. Evaluation of the pulmonary embolism rule out criteria (PERC rule) in children evaluated for suspected pulmonary embolism

Evaluation of the pulmonary embolism rule out criteria (PERC rule) in children evaluated for suspected pulmonary embolism The pulmonary embolism rule out criteria (PERC) reliably predicts a low probability of PE in adults. We examine the diagnostic accuracy of the objective components of the PERC rule in children previously tested for PE.Children aged 5-17 who had a D-dimer or pulmonary vascular imaging ordered from 2004 to 2014 in a large multicenter hospital network were identified by query

2018 EvidenceUpdates

16. Pulmonary embolism

Pulmonary embolism Top results for pulmonary embolism - Trip Database or use your Google+ account Liberating the literature ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 (...) or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for pulmonary embolism The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other

2018 Trip Latest and Greatest

17. Percutaneous extraction of an embolized progesterone contraceptive implant from the pulmonary artery (PubMed)

Percutaneous extraction of an embolized progesterone contraceptive implant from the pulmonary artery The Nexplanon® implant is a commonly used radiopaque contraceptive device that contains progestogen associated with an ethylene vinyl-acetate copolymer resulting in a slow release of the active hormonal ingredient. It is inserted into the subdermal connective tissue and provides contraceptive efficacy for up to 3 years. Device removal for clinical, personal or device "end-of-life span" reasons (...) is straightforward. In rare cases, implant migration can occur locally within centimeters of the insertion site. Distant device embolization is extremely rare and can result in complications including chest pain, dyspnoea, pneumothorax and thrombosis or prevent conception until the active ingredient is depleted. We present one such case, where a Nexplanon® implant embolized into the pulmonary artery of a young female patient. We describe the initial "missed" diagnosis of embolized device on a chest radiograph

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2018 Open access journal of contraception

18. Outcomes following a negative computed tomography pulmonary angiography according to pulmonary embolism prevalence: a meta-analysis of the management outcome studies

Outcomes following a negative computed tomography pulmonary angiography according to pulmonary embolism prevalence: a meta-analysis of the management outcome studies Essentials Computed tomographic pulmonary angiography (CTPA) is used to exclude pulmonary embolism. This meta-analysis explores the occurrence of venous thromboembolic events (VTE) after a CTPA. Occurrence of VTE after a negative CTPA is ˜8% in study subgroups with a prevalence of PE ≥ 40%. CTPA may be insufficient to safely rule (...) out VTE as a stand-alone diagnostic test for this subgroup.Background Outcome studies have reported the safety of computed tomographic pulmonary angiography (CTPA) as a stand-alone imaging technique to rule out pulmonary embolism (PE). Whether this can be applied to all clinical probabilities remains controversial. Objectives We performed a meta-analysis to determine the proportion of patients with venous thromboembolic events (VTE) despite a negative CTPA according to pretest PE prevalence

2018 EvidenceUpdates

19. Prognostic impact of copeptin in pulmonary embolism: a multicentre validation study

Prognostic impact of copeptin in pulmonary embolism: a multicentre validation study To externally validate the prognostic impact of copeptin, either alone or integrated in risk stratification models, in pulmonary embolism (PE), we performed a post hoc analysis of 843 normotensive PE patients prospectively included in three European cohorts.Within the first 30 days, 21 patients (2.5%, 95% CI 1.5-3.8) had an adverse outcome and 12 (1.4%, 95% CI 0.7-2.5) died due to PE. Patients with copeptin ≥24

2018 EvidenceUpdates

20. Pulmonary embolism

Pulmonary embolism Evidence Maps - Trip Database or use your Google+ account Liberating the literature ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4

2018 Trip Evidence Maps