Witkin Alison S
Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachussets, USA.
Curr Opin Cardiol. 2017 Nov;32(6):672-678. doi: 10.1097/HCO.0000000000000455.
Acute pulmonary embolism is a life-threatening condition that can lead to both acute and long-term morbidity and mortality. Patients with acute pulmonary embolism are at risk for significant complications including the development of chronic pulmonary embolism and chronic thromboembolic pulmonary hypertension. This review will describe the rationale for and structure of pulmonary embolism response teams, with a focus on the recognition and treatment of patients with persistent morbidity following pulmonary embolism.
For patients with intermediate and high-risk pulmonary embolism, a myriad of treatment options exist, ranging from anticoagulation alone to surgical embolectomy and hemodynamic support with extracorporeal membrane oxygenation. Optimizing treatment for these patients requires rapid assessment and multidisciplinary cooperation. Over the last five years, the pulmonary embolism response team has emerged as a mechanism to facilitate this care.
Pulmonary embolism response teams can streamline and expedite care for patients with intermediate and high-risk pulmonary embolism. However, the care for patients with acute pulmonary embolism does not end at hospital discharge. It is essential to ensure adequate follow-up and identify patients with persistent symptoms and impaired quality of life, particularly those who may have symptomatic chronic pulmonary embolism or chronic thromboembolic pulmonary hypertension.
急性肺栓塞是一种危及生命的疾病，可导致急性和长期的发病及死亡。急性肺栓塞患者有发生严重并发症的风险，包括慢性肺栓塞和慢性血栓栓塞性肺动脉高压的形成。本综述将描述肺栓塞应对团队的基本原理和架构，重点关注肺栓塞后持续发病患者的识别和治疗。
对于中高危肺栓塞患者，存在多种治疗选择，从单纯抗凝到手术取栓以及体外膜肺氧合的血流动力学支持。优化这些患者的治疗需要快速评估和多学科合作。在过去五年中，肺栓塞应对团队已成为促进这种治疗的一种机制。
肺栓塞应对团队可以简化并加快中高危肺栓塞患者的治疗。然而，急性肺栓塞患者的治疗并不在出院时结束。确保充分的随访并识别有持续症状和生活质量受损的患者至关重要，特别是那些可能患有症状性慢性肺栓塞或慢性血栓栓塞性肺动脉高压的患者。
