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重症监护病房中的高危和中危肺栓塞

High and intermediate risk pulmonary embolism in the ICU.

作者信息

Millington Scott J, Aissaoui Nadia, Bowcock Emma, Brodie Daniel, Burns Karine E A, Douflé Ghislaine, Haddad François, Lahm Tim, Piazza Gregory, Sanchez Olivier, Savale Laurent, Vieillard-Baron Antoine

机构信息

Critical Care, The University of Ottawa/The Ottawa Hospital, Ottawa, ON, Canada.

Service de Médecine Intensive-Réanimation, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP). Centre & Université Paris Cité, Paris, France.

出版信息

Intensive Care Med. 2024 Feb;50(2):195-208. doi: 10.1007/s00134-023-07275-6. Epub 2023 Dec 19.

Abstract

Pulmonary embolism (PE) is a common and important medical emergency, encountered by clinicians across all acute care specialties. PE is a relatively uncommon cause of direct admission to the intensive care unit (ICU), but these patients are at high risk of death. More commonly, patients admitted to ICU develop PE as a complication of an unrelated acute illness. This paper reviews the epidemiology, diagnosis, risk stratification, and particularly the management of PE from a critical care perspective. Issues around prevention, anticoagulation, fibrinolysis, catheter-based techniques, surgical embolectomy, and extracorporeal support are discussed.

摘要

肺栓塞(PE)是一种常见且重要的医疗急症,所有急性护理专科的临床医生都会遇到。PE是直接入住重症监护病房(ICU)相对不常见的原因,但这些患者死亡风险很高。更常见的情况是,入住ICU的患者会发生PE,作为无关急性疾病的并发症。本文从重症监护的角度综述了PE的流行病学、诊断、风险分层,尤其是管理。讨论了预防、抗凝、纤维蛋白溶解、基于导管的技术、外科血栓切除术和体外支持等问题。

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