Pulmonary embolism discharge care and long term treatment: Difference between revisions
No edit summary |
|||
| Line 15: | Line 15: | ||
Patients having a [[Pulmonary embolism diagnosis#Wells score|low-risk score]] and do not require supplemental oxygen are potential candidates for early discharge and outpatient treatment. Patients with absent [[RV dysfunction|Right ventricular dysfunction]] and a normal [[troponin]] level can be discharged and put on out-patient treatment<ref name="pmid20592294">{{cite journal| author=Agnelli G, Becattini C| title=Acute pulmonary embolism. | journal=N Engl J Med | year= 2010 | volume= 363 | issue= 3 | pages= 266-74 | pmid=20592294 | doi=10.1056/NEJMra0907731 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20592294 }} </ref>. | Patients having a [[Pulmonary embolism diagnosis#Wells score|low-risk score]] and do not require supplemental oxygen are potential candidates for early discharge and outpatient treatment. Patients with absent [[RV dysfunction|Right ventricular dysfunction]] and a normal [[troponin]] level can be discharged and put on out-patient treatment<ref name="pmid20592294">{{cite journal| author=Agnelli G, Becattini C| title=Acute pulmonary embolism. | journal=N Engl J Med | year= 2010 | volume= 363 | issue= 3 | pages= 266-74 | pmid=20592294 | doi=10.1056/NEJMra0907731 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20592294 }} </ref>. | ||
==Discharge | ==Discharge medications== | ||
Outpatient administration of [[LMWH]] is as safe as unfractionated heparin administered in hospital for the treatment of DVT. | Outpatient administration of [[LMWH]] is as safe as unfractionated heparin administered in hospital for the treatment of DVT. | ||
Revision as of 15:27, 26 April 2012
|
Pulmonary Embolism Microchapters |
|
Diagnosis |
|---|
|
Pulmonary Embolism Assessment of Probability of Subsequent VTE and Risk Scores |
|
Treatment |
|
Follow-Up |
|
Special Scenario |
|
Trials |
|
Case Studies |
|
Pulmonary embolism discharge care and long term treatment On the Web |
|
FDA on Pulmonary embolism discharge care and long term treatment |
|
CDC on Pulmonary embolism discharge care and long term treatment |
|
Pulmonary embolism discharge care and long term treatment in the news |
|
Blogs on Pulmonary embolism discharge care and long term treatment |
|
Directions to Hospitals Treating Pulmonary embolism discharge care and long term treatment |
|
Risk calculators and risk factors for Pulmonary embolism discharge care and long term treatment |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editors-in-Chief: Ujjwal Rastogi, MBBS [2]
Overview
Pulmonary embolism patient are at increased risk of second attack of PE (If un-treated almost 1/3 patient die, usually from recurrent PE) and therefore a patient should be discharged only after proper diagnosis and discharge medication. Information pertaining the safety of outpatient treatment of pulmonary embolism is still inadequate due to the lack of a randomized control trial comparing in-patient and outpatient management.
Discharge criteria
High-risk PE patients have a 30-day mortality of greater than 15%, and thus hospital admission is necessary[1].
Hemodynamically stability is not the criteria for discharge, patients who are hemodynamically stable but with right ventricular dysfunction should be admitted.
Patients having a low-risk score and do not require supplemental oxygen are potential candidates for early discharge and outpatient treatment. Patients with absent Right ventricular dysfunction and a normal troponin level can be discharged and put on out-patient treatment[2].
Discharge medications
Outpatient administration of LMWH is as safe as unfractionated heparin administered in hospital for the treatment of DVT.
References
- ↑ Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P, Bengel F, Brady AJ, Ferreira D, Janssens U, Klepetko W, Mayer E, Remy-Jardin M, Bassand JP (2008). "Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC)". Eur. Heart J. 29 (18): 2276–315. doi:10.1093/eurheartj/ehn310. PMID 18757870. Retrieved 2011-12-07. Unknown parameter
|month=ignored (help) - ↑ Agnelli G, Becattini C (2010). "Acute pulmonary embolism". N Engl J Med. 363 (3): 266–74. doi:10.1056/NEJMra0907731. PMID 20592294.