Koslowsky Jonathan, Kakkar Amit, Faillace Robert T, Sokol Seth I
Department of Medicine, Division of Cardiology NYC Health + Hospitals, Jacobi Medical Center, Bronx, NY, USA.
Curr Pharm Des. 2022;28(7):535-549. doi: 10.2174/1381612827666211115153910.
Pulmonary embolism (PE) is the third leading cause of cardiovascular mortality. Patients with PE can present with a wide array of symptoms, ranging from mild to life threatening. The mainstay of PE treatment is anticoagulation; however, many advanced options are available for more severe patients, including catheter- directed interventions, surgical treatments, and hemodynamic support. Although different risk scores and clinical guidelines exist, the primary treating teams are frequently left uncertain on the most suitable treatment for a specific complex patient. Pulmonary Embolism Response Teams (PERT), composed of multidisciplinary experts, have emerged and been implemented in many centers and are available 24 hours a day to help guide the primary team. PERTs have changed the way complex PE patients are managed. In centers with a PERT, teams are called upon very frequently, and there is a significant increase in the use of advanced treatments for PE, although there are differences between centers based upon the center's specific PERT protocol and available capabilities. As PE is an evolving area, and more studies are necessary, PERTs around the world can help advance the field and improve the treatment offered to PE patients.
肺栓塞(PE)是心血管疾病死亡的第三大主要原因。PE患者的症状表现多种多样,从轻症到危及生命不等。PE治疗的主要方法是抗凝;然而,对于病情更严重的患者,有许多先进的治疗选择,包括导管介入治疗、手术治疗和血流动力学支持。尽管存在不同的风险评分和临床指南,但主要治疗团队常常难以确定针对特定复杂患者的最合适治疗方法。由多学科专家组成的肺栓塞应对小组(PERT)已出现并在许多中心实施,且每天24小时提供服务,以帮助指导主要治疗团队。PERT改变了复杂PE患者的管理方式。在设有PERT的中心,团队被频繁召集,PE的先进治疗方法的使用显著增加,不过基于各中心特定的PERT方案和可用能力,不同中心之间存在差异。由于PE是一个不断发展的领域,还需要更多研究,世界各地的PERT有助于推动该领域发展,并改善为PE患者提供的治疗。