Pulmonary embolism: Difference between revisions
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* Massive: mortality 55-70% |
* Massive: mortality 55-70% |
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== Management == |
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{| class="wikitable" |
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![[CrCl]] |
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![[BMI]] |
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![[Enoxaparin]] |
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![[Dalteparin]] |
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![[Tinzaparin]] |
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!Unfractionated [[Heparin]] |
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|- |
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| rowspan="2" |≥30 |
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|<40 |
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|1 mg/kg SC q12h, or |
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1.5 mg/kg SC q24h |
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|200 units/kg SC q24h, or |
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100 units/kg SC q12h |
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| rowspan="2" |175 units/kg SC q24h |
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| rowspan="3" |IV bolus, with continusuous infusion to titrate to anti-Xa 0.3 to 0.7 IU/mL (or corresponding aPTT) |
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|- |
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|≥40 |
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|1 mg/kg SC q12h |
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|100 units/kg SC q12h |
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|- |
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|<30 |
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|Any |
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|Aoivd |
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|Avoid |
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|Avoid |
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|} |
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[[Category:Thrombosis]] |
[[Category:Thrombosis]] |
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[[Category:Respirology]] |
[[Category:Respirology]] |
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Latest revision as of 14:45, 11 December 2023
Definition
- Embolism involving the pulmonary arteries, most often thromboembolism, though other etiologies are possible
Classification
- Massive PE, defined by having all of:
- Hypotension, with SBP <90 OR a decrease of 40 for at least 15 minutes; and
- Requiring pressors; and
- Not explained by another cause
- Submassive PE: RV dysfunction or troponins/BNP elevated
- Low risk: no RV dysfunction, no hypotension or shock, troponins/BNP normal
Prognosis
- Low risk: mortality <1%
- Sub-massive: mortallity 6-12%
- Massive: mortality 55-70%
Management
| CrCl | BMI | Enoxaparin | Dalteparin | Tinzaparin | Unfractionated Heparin |
|---|---|---|---|---|---|
| ≥30 | <40 | 1 mg/kg SC q12h, or
1.5 mg/kg SC q24h |
200 units/kg SC q24h, or
100 units/kg SC q12h |
175 units/kg SC q24h | IV bolus, with continusuous infusion to titrate to anti-Xa 0.3 to 0.7 IU/mL (or corresponding aPTT) |
| ≥40 | 1 mg/kg SC q12h | 100 units/kg SC q12h | |||
| <30 | Any | Aoivd | Avoid | Avoid |
