Document Detail

Pulmonary embolism. Prophylaxis diagnosis and treatment.
MedLine Citation:
PMID:  970590     Owner:  NLM     Status:  MEDLINE    
The natural history diagnosis and immediate treatment of patients suffering from pulmonary embolism has been discussed. Anaesthetists should use their influence to bring about a high standard of prophylactic care against deep venous thrombosis and consequently of pulmonary embolism. They are likely to be involved in the resuscitation and treatment in intensive care units of those cases who suffer from major symptoms and massive emboli and some of them will rarely be involved in anaesthetising for pulmonary embolectomy aided by cardiopulmonary by-pass and, less rarely, for IVC ligation or plication and venous disobliteration. Anticoagulant drugs appear to limit the mortality of pulmonary embolism to 5%. The mortality of IVC ligation or plication varies in different reports from 2 to 50%; it should therefore be reserved for the special indications which have been discussed. There is also an incidence of recurrent pulmonary embolism after IVC ligation and plication and leg troubles from stasis in about 30% of cases. Streptokinase is usually indicated in the immediate treatment of major pulmonary emboli which cause shock and severe distress with an immediate threat to life. In hospitals having access to cardiopulmonary by-pass, pulmonary embolectomy has a small role to play in major emboli with cardiovascular collapse, if surgery can start within 2 hours and pulmonary angiography is available. Cardiopulmonary by-pass on its own may be life-saving in supporting the circulation while the clot fragments. If cardiac arrest occurs, external cardiac massage should be undertaken as it is sometimes successful and disseminates and fragments the clot in the pulmonary artery.
D G Price
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anaesthesia     Volume:  31     ISSN:  0003-2409     ISO Abbreviation:  Anaesthesia     Publication Date:  1976 Sep 
Date Detail:
Created Date:  1976-12-01     Completed Date:  1976-12-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  925-32     Citation Subset:  AIM; IM    
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MeSH Terms
Cardiopulmonary Bypass
Dextrans / therapeutic use
Heparin / therapeutic use
Pulmonary Artery / radiography
Pulmonary Embolism* / diagnosis,  therapy
Radionuclide Imaging
Streptokinase / therapeutic use
Thrombophlebitis / prevention & control
Vena Cava, Inferior
Reg. No./Substance:
9004-54-0/Dextrans; 9005-49-6/Heparin; EC 3.4.-/Streptokinase

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