Pulmonary Embolism in the ICU , An Issue of Critical Care Clinics

1st Edition, Volume 36-3 - June 1, 2020
Editors: Geno J. Merli, Bharat Awsare, Michael Baram
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 7 1 2 9 3 - 4
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 7 1 2 9 4 - 1

This issue of Critical Care Clinics, guest edited by Drs. Geno Merli, Bharat Awsare, and Michael Baram, focuses on Pulmonary Embolism in the ICU. This is one of four issues each… Read more

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This issue of Critical Care Clinics, guest edited by Drs. Geno Merli, Bharat Awsare, and Michael Baram, focuses on Pulmonary Embolism in the ICU. This is one of four issues each year selected by the series consulting editor, Dr. John Kellum. Articles in this issue include, but are not limited to: Making the Diagnosis of Pulmonary Embolism: Stable Versus Unstable; Risk Stratification; Overview of Management of Sub-massive and Massive Pulmonary Embolism; Standard Therapy: Systemic Thrombolytics; IR Therapy: IVC Filter and Catheter-based Therapies; Surgical Therapy: Embolectomy; Supportive Therapy: Management of Acute RV Failure; Supportive Therapy: ECMO/RVAD; Special Considerations; Therapy in Sub-populations; and Post-ICU Follow-up.

Cover image
Title page
Table of Contents
Copyright
Contributors
Forthcoming Issues
Erratum
Preface
Pulmonary Embolism in Intensive Care Unit
Key points
Introduction
Epidemiology of pulmonary embolism
Pathophysiology
Role of the intensive care unit
The intensive care unit and multiorgan failure
Pulmonary embolism response teams
Summary
Risk Stratification of Pulmonary Embolism
Key points
Introduction
Clot burden
Clinical parameters
Markers of right ventricular dysfunction
Summary
Overview of Management of Intermediate- and High-Risk Pulmonary Embolism
Key points
Introduction
Definitions
Potential benefits of acute pulmonary embolism therapy
Acute pulmonary embolism: supportive therapy and general concepts
Treatment of high-risk pulmonary embolism
Treatment of intermediate-risk pulmonary embolism
Summary
Thrombolysis in Pulmonary Embolism: An Evidence-Based Approach to Treating Life-Threatening Pulmonary Emboli
Key points
Introduction
Rationale for thrombolysis
The evolving evidence for thrombolysis
Massive pulmonary embolism
Submassive pulmonary embolism
Practical considerations in thrombolysis
Summary
Interventional Radiology Therapy: Inferior Vena Cava Filter and Catheter-based Therapies
Key points
Catheter-directed therapies
Inferior vena cava filters
Summary
Surgical Pulmonary Embolectomy
Key points
Introduction
Indications
Current surgical approach
Supporting evidence
Comparisons with other therapies
Summary
Management of Right Ventricular Failure in Pulmonary Embolism
Key points
Introduction
Pathophysiology of right ventricular failure
Preload optimization: volume management
Early priority for clot reduction
The role for vasopressors and inotropes
Maintaining systemic pressure and coronary perfusion: vasopressors
Maintaining cardiac output: inotropes
Managing right ventricular afterload: pulmonary vasodilators
Managing respiratory failure: intubation and mechanical ventilation
Managing right ventricular failure with mechanical support: extracorporeal membrane oxygenation and right ventricular assist device
Summary
Supportive Therapy: Extracorporeal Membrane Oxygenation
Key points
Introduction
Cardiac arrest
Cardiogenic shock
Pregnancy
Cannulation strategies
Pulmonary embolism response team
Summary
Special Considerations in Pulmonary Embolism: Clot-in-Transit and Incidental Pulmonary Embolism
Key points
Introduction
Clot-in-transit
Epidemiology
Types of right heart thrombi
Pathophysiology
Diagnosis
Prognosis
Treatment
Outcomes
Incidental pulmonary embolism
Summary
Pulmonary Embolism in the Intensive Care Unit: Therapy in Subpopulations
Key points
The pregnant patient
Risk factors
Incidence
Pathophysiology of pulmonary embolism in the pregnant patient
Diagnosis
Imaging
Treatment
Advanced therapies
Systemic thrombolysis
Catheter-directed therapies
Surgical embolectomy
Extracorporeal membrane oxygenation
Inferior vena cava filters
Cancer and pulmonary embolism
Diagnosis
Risk assessment
Treatment
Thrombolytic therapy
Catheter-directed therapies and pulmonary embolectomy
Inferior vena cava filters
Summary
Post-Intensive Care Unit Follow-up of Pulmonary Embolism
Key points
Introduction
Duration of intensive care unit stay
Outpatient follow-up
Duration of anticoagulation
Assessment for post–pulmonary embolism sequelae, including chronic thromboembolic pulmonary hypertension, chronic thromboembolic disease, and post–pulmonary embolism syndrome
Summary

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Pulmonary Embolism in the ICU , An Issue of Critical Care Clinics

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Institutional subscription on ScienceDirect

Geno J. Merli

Michael Baram