Search

The objective of the study is to assess the efect of thrombolitic therapy on clinical prognostic markers in patients with intermediate-high risk pulmonary embolism compared to clasic therapy, and also the assessment of the bleeding risk associated with thrombolitic therapy. Material and methods. We included 82 consecutive patients with intermediate-high risk pulmonary embolism, which were divided in two groups: study group (thrombolysed) and control group (treated with unfractioned heparine alone). Patients with lower bleeding risk were included in control group. Patients were assessed regarding the right ventricle dysfunction markers (both imagistic and biochemical) on admision and on 48 h. The early (7th day) mortality rate and hemodinamic instability rate were evaluated in the two groups, also the major bleeding rate. Outcomes. We proved a statistical significant lower mortality rate in the study group, with no difference regarding the major bleedings. Meanwhile, the hemodinamic instability was lower in the study group compared to control group. Conclusions. The proper patient selection with intermediate-high pulmonary embolism for thrombolitic therapy can bring important benefits in terms of mortality and bleeding complications

The objective of the study is to assess the efect of thrombolitic therapy on clinical prognostic markers in patients with intermediate-high risk pulmonary embolism compared to clasic therapy, and also the assessment of the bleeding risk associated with thrombolitic therapy. Material and methods. We included 82 consecutive patients with intermediate-high risk pulmonary embolism, which were divided in two groups: study group (thrombolysed) and control group (treated with un fractioned heparine alone). Patients with lower bleeding risk were included in control group. Patients were assessed regarding the right ventricle dysfunction markers (both imagistic and biochemical) on admission and on 48 h. The early (7th day) mortality rate and hemodinamic instability rate were evaluated in the two groups, also the major bleeding rate. Outcomes. We proved a statistical significant lower mortality rate in the study group, with no difference regarding the major bleedings. Meanwhile, the hemodinamic instability was lower in the study group compared to control group. Conclusions. The proper patient selection with intermediate-high pulmonary embolism for thrombolitic therapy can bring important benefits in terms of mortality and bleeding complications. [ABSTRACT FROM AUTHOR]

Background: The diagnosis of pulmonary embolism is difficult because the clinical diagnosis is nonspecific and all of the objective tests have limitations. The assay for plasma d-dimer may be useful as an exclusion test if results are negative. We conducted a prospective cohort study that evaluated the clinical utility (usefulness) of an automated quantitative d-dimer test in the diagnosis of patients with suspected pulmonary embolism. Methods: Consecutive eligible patients who had clinically suspected PE with nondiagnostic lung scans or negative helical CT scan of the chest results underwent d-dimer testing. Results: The d-dimer results were negative in 11 of 103 inpatients (10.6%, 95% confidence interval [CI], 5.5 to 18.3%) and 7 of 22 outpatients (31.8%, 95% CI, 13.9 to 54.9%; p = 0.02). Conclusions: Measurement of plasma d-dimer is of limited clinical utility for inpatients with clinically suspected pulmonary embolism and nondiagnostic lung scans or negative helical CT results at a US academic health center. [ABSTRACT FROM AUTHOR]