Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Department of Emergency Medicine, Center for Vascular Emergencies, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Semin Thromb Hemost. 2016 Nov;42(8):857-864. doi: 10.1055/s-0036-1593541. Epub 2016 Oct 21.
Pulmonary embolism is a common and often life-threatening event. Treatment options include anticoagulation alone, catheter-directed therapies, and surgical thromboembolectomy. While guidelines exist, there is often controversy over which treatment is most appropriate, particularly for intermediate-risk patients. The traditional care model, in which the primary team is responsible for consulting the appropriate specialists, may be inadequate and inefficient for emergent situations, as ensuring coordination and communication between various consulting services can be a time consuming and confusing process. The Pulmonary Embolism Response Team (PERT) model was developed to improve the quality and efficiency of care for patient with intermediate- and high-risk pulmonary embolism. Activation of the PERT allows for rapid, multidisciplinary discussion among dedicated specialists, which typically includes members of the cardiology, emergency medicine, hematology, pulmonary/critical care, and surgical services. While the majority of patients are still treated with anticoagulation alone, in the event that a more invasive approach is deemed necessary, the team expedites this process. Over the last several years, the PERT model has been adopted at more than 75 health care institutions and may represent a new standard of care.
肺栓塞是一种常见且常常危及生命的事件。治疗方案包括单独抗凝、导管引导的治疗和手术血栓切除术。尽管存在指南，但对于哪种治疗最适合，尤其是对于中危患者，常常存在争议。传统的护理模式是由初级团队负责咨询适当的专家，但对于紧急情况来说，这种模式可能不够充分和低效，因为确保各种咨询服务之间的协调和沟通可能是一个耗时且令人困惑的过程。肺栓塞反应团队 (PERT) 模式的开发是为了提高中高危肺栓塞患者的护理质量和效率。PERT 的激活允许专门的专家之间进行快速的多学科讨论，通常包括心脏病学、急诊医学、血液学、肺/重症监护和外科服务的成员。虽然大多数患者仍单独接受抗凝治疗，但如果认为需要更具侵入性的方法，则团队会加快这一过程。在过去几年中，PERT 模式已在 75 多家医疗机构中采用，可能代表着一种新的护理标准。
