From the Department of Cardiology, Heart Institute, Hadassah Medical Center, Hebrew University of Jerusalem, Israel.
Department of Medicine, Mount Sinai Morningside, New York, NY.
Crit Pathw Cardiol. 2021 Jun 1;20(2):57-62. doi: 10.1097/HPC.0000000000000252.
Venous thromboembolism (VTE), the combined syndromes of deep vein thrombosis (DVT) and pulmonary embolism (PE), is currently the third most frequent acute cardiovascular syndrome globally behind myocardial infarction and stroke. PE carries substantial mortality. In the past decade, we have seen a remarkable improvement in new diagnostic tools as well as advances in therapeutic options to manage patients with PE. Still, even with recently updated society guidelines, the management of intermediate and high-risk PE requires clinician expertise and judgment. To aid healthcare providers caring for patients with acute PE, we have developed a novel, comprehensive yet straightforward, pathway for the management of patients with PE. We believe this pathway can be used in many healthcare systems around the globe. Our pathway for the diagnosis and management of PE is divided into 3 steps: the diagnosis of PE, the acute management of patients with PE, and recommendations for chronic management. The pathway requires classification of the PE by the risk of mortality and thus leads to the appropriate intensity of initial care, intervention, and monitoring. The Pulmonary Embolism Response Team (PERT) is a multispecialty team designed to guide the decision-making for the individual patient with intermediate-high or high-risk PE. The PERT team brings together specialists from different disciplines. The team convenes in real time via a platform such as WhatsApp or text messages to communicate clinical data, discuss the options, and provide consensus for a course of management. The success of this pathway to manage PE depends heavily on developing a collaborative group of specialists dedicated to provide care at each stage to patients with PE.
静脉血栓栓塞症（VTE），即深静脉血栓形成（DVT）和肺栓塞（PE）的联合综合征，目前是全球第三大常见的急性心血管综合征，仅次于心肌梗死和中风。PE 具有很高的死亡率。在过去的十年中，我们看到了新的诊断工具的显著改进，以及治疗选择的进步，以管理 PE 患者。尽管最近更新了社会指南，但中间和高危 PE 的管理仍需要临床医生的专业知识和判断。为了帮助照顾急性 PE 患者的医疗保健提供者，我们为 PE 患者的管理制定了一个新颖、全面而简单的综合途径。我们相信，这种途径可以在全球许多医疗保健系统中使用。我们的 PE 诊断和管理途径分为 3 个步骤：PE 的诊断、PE 患者的急性管理和慢性管理建议。该途径需要根据死亡率风险对 PE 进行分类，从而导致初始护理、干预和监测的适当强度。肺栓塞反应团队（PERT）是一个多专业团队，旨在为中高危或高危 PE 患者的个体决策提供指导。PERT 团队汇集了来自不同学科的专家。该团队通过 WhatsApp 或短信等平台实时开会，交流临床数据，讨论各种选择，并为管理方案提供共识。管理 PE 的这条途径的成功在很大程度上取决于培养出一个专门为 PE 患者在每个阶段提供护理的协作专家团队。
