Pulmonary embolism discharge care and long term treatment
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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.