Aggressive Treatment of Intermediate-Risk Patients with Acute Symptomatic Pulmonary Embolism

被引：12

作者：

Jimenez, David ^{[1
,2
]}

Bikdeli, Behnood ^{[3
,4
]}

Marshall, Peter S. ^{[5
]}

Tapson, Victor ^{[6
]}

机构：

[1] Hosp Ramon & Cajal, Resp Dept, Ctra Colmenar Km 9,100, E-28034 Madrid, Spain

[2] Univ Alcala, IRYCIS, Dept Med, Ctra Colmenar Km 9,100, Madrid 28034, Spain

[3] Columbia Univ, Med Ctr, New York Presbyterian Hosp, Div Cardiol,Dept Med, 622 West 168th St, New York, NY 10032 USA

[4] Yale Univ, Sch Med, CORE, 333 Cedar St, New Haven, CT 06510 USA

[5] Yale Sch Med, Dept Med, Sect Pulm Crit Care & Sleep Med, 333 Cedar St, New Haven, CT 06520 USA

[6] Cedars Sinai Med Ctr, Dept Med, 8700 Beverly Blvd, Los Angeles, CA 90048 USA

来源：

CLINICS IN CHEST MEDICINE | 2018年 / 39卷 / 03期

基金：

美国国家卫生研究院;

关键词：

Pulmonary embolism; Submassive; Intermediate-risk; Thrombolysis; Reperfusion; Prognosis; RIGHT-VENTRICULAR DYSFUNCTION; INHALED NITRIC-OXIDE; BRAIN NATRIURETIC PEPTIDE; DEEP-VEIN THROMBOSIS; NORMOTENSIVE PATIENTS; PROGNOSTIC VALUE; THROMBOLYTIC THERAPY; SEVERITY INDEX; IDENTIFICATION; MULTICENTER;

D O I：

10.1016/j.ccm.2018.04.011

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Contemporary studies of acute pulmonary embolism (PE) have evaluated the role of thrombolytics in intermediate-risk PE. Significant findings are that thrombolytic therapy may prevent hemodynamic deterioration and all-cause mortality but increases major bleeding. Benefits and harms are finely balanced with no convincing net benefit from thrombolytic therapy among unselected patients. Among patients with intermediate-risk PE, additional prognostic factors or subtle hemodynamic changes might alter the risk-benefit assessment in favor of thrombolytic therapy before obvious hemodynamic instability.

引用

页码：569 / +

页数：14

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