Pulmonary embolism: Difference between revisions

Latest revision as of 10:45, 11 December 2023

Embolism involving the pulmonary arteries, most often thromboembolism, though other etiologies are possible

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

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)
≥30	≥40	1 mg/kg SC q12h	100 units/kg SC q12h	175 units/kg SC q24h
<30	Any	Aoivd	Avoid	Avoid

@@ Line 18: / Line 18: @@
 * Massive: mortality 55-70%
+== Management ==
+{| class="wikitable"
+![[CrCl]]
+![[BMI]]
+![[Enoxaparin]]
+![[Dalteparin]]
+![[Tinzaparin]]
+!Unfractionated [[Heparin]]
+|-
+| rowspan="2" |≥30
+|<40
+|1 mg/kg SC q12h, or
+.5 mg/kg SC q24h
+|200 units/kg SC q24h, or
+units/kg SC q12h
+| rowspan="2" |175 units/kg SC q24h
+| rowspan="3" |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
+|}
 [[Category:Thrombosis]]
 [[Category:Respirology]]