scholarly journals Alveolar dead space and capnographic variables before and after thrombolysis in patients with acute pulmonary embolism

2008 ◽  
pp. 9 ◽  
Author(s):  
Moreira ◽  
Terzi ◽  
Carvalho ◽  
Neto ◽  
Paschoal
Keyword(s):  
Pulmonary Embolism ◽  
Dead Space ◽  
Acute Pulmonary Embolism ◽  
Alveolar Dead Space ◽  
Before And After

scholarly journals Use of the Alveolar Dead Space Fraction (Vd/Vt) and Plasma D-dimers to Exclude Acute Pulmonary Embolism in Ambulatory Patients

1997 ◽  
Vol 4 (9) ◽  
pp. 856-863 ◽  
Author(s):  
Jefsrey A. Kline ◽  
Suzy Meek ◽  
Dawn Boudrow ◽  
Douglas Warner ◽  
Stephen Colucciello
Keyword(s):  
Pulmonary Embolism ◽  
Dead Space ◽  
Acute Pulmonary Embolism ◽  
Alveolar Dead Space ◽  
Ambulatory Patients

scholarly journals Dead Space Ventilation Parallels Changes in Scintigraphic Vascular Obstruction at Recurrence of Pulmonary Embolism and after Thrombolytic Therapy: A Case Report

1998 ◽  
Vol 5 (3) ◽  
pp. 215-218 ◽  
Author(s):  
Marc A Rodger ◽  
Gwynne Jones ◽  
Francois Raymond ◽  
Daniel Lalonde ◽  
Mike Proulx ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Thrombolytic Therapy ◽  
Dead Space ◽  
Heparin Therapy ◽  
Alveolar Dead Space ◽  
Right Heart ◽  
Vascular Obstruction ◽  
Right Heart Dysfunction ◽  
Pulmonary Vascular Obstruction ◽  
Dead Space Ventilation

Physiological and alveolar dead space ventilation both increase in pulmonary embolism (PE) in proportion to the severity of vascular obstruction. The case of a patient with recurrent PE while on heparin therapy is presented. The recurrence was characterized clinically by severe pulmonary vascular obstruction and right heart dysfunction. The patient was treated with thrombolytic therapy, with excellent clinical and scintigraphic resolution. Dead space ventilation measurements at baseline, at the time of recurrence and after thrombolytic therapy are presented. The potential utility of dead space ventilation measurements for PE diagnosis and management are discussed.

Functional State of Right Ventricular Myocardium in Patients With Acute Pulmonary Embolism Before and After Thrombolytic Therapy

Kardiologiia ◽  
2014 ◽  
Vol 5_2014 ◽  
pp. 29-33 ◽  
Author(s):  
A.A. Karpenko Karpenko ◽  
Yu.E. Klevanets Klevanets ◽  
S.P. Mironenko Mironenko ◽  
A.N. Shilova Shilova ◽  
N.V. Matveeva Matveeva ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Thrombolytic Therapy ◽  
Right Ventricular ◽  
Functional State ◽  
Acute Pulmonary Embolism ◽  
Ventricular Myocardium ◽  
Before And After

scholarly journals Percutaneous catheter-directed treatment in intermediate-high risk acute pulmonary embolism. Hemodynanical and right heart function-related parameters changes and short-term outcomes

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
J Gradoli Palmero ◽  
V Vidal Urrutia ◽  
E Rumiz Gonzalez ◽  
E Valero Picher ◽  
J Abdala Lizarraga ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Right Ventricle ◽  
Acute Pulmonary Embolism ◽  
Minor Bleeding ◽  
Early Improvement ◽  
Percutaneous Catheter ◽  
Hemodynamic Deterioration ◽  
Systemic Thrombolytic Therapy ◽  
Before And After

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Acute pulmonary embolism (PE) is the third cause of cardiovascular mortality, right after acute myocardial infarction and stroke. Systemic thrombolytic therapy (SLT) restores pulmonary perfusion earlier than low molecular-weight heparin, but with a significantly higher risk of major bleeding. Currently, in our area there is a lack of standardized protocols for the management of patients in which SLT is contraindicated.  Objective The purpose of our study was to evaluate the safety and efficacy of percutaneous catheter-directed treatment (PCT) for high-intermediate risk PE (HIRPE) patients with hemodynamic deterioration on anticoagulation treatment. Methods We consecutively included all patients with HIRPE patients who underwent PCT in our center. Before and after PCT clinical, echocardiographic and hemodynamic variables were collected, as well as events (major or minor bleeding, death) during follow-up. Results From February 2018 to February 2020, 20 patients with HIRPE underwent PCT. The mean age of our cohort was 62 (52 - 73), and 46.6% were women. The indication for PCT was absolute contraindication for SLT (9 patients, 45%), followed by high bleeding risk (8 patients, 40%) and failure of SLT. Vascular access was mainly performed through femoral vein (12 patients, 60%) followed by a peripheral vein of the superior limb (8 patients, 40%). During pulmonary angiography, lobar arteries occlusion was observed in 60% of the cases, with involvement of main pulmonary arteries in 40% of the cases. Local thrombolysis with Alteplase was performed in 17 cases (85%), and in 8 cases it was decided to carry-out a thrombus fragmentation-aspiration strategy. We observed and early improvement of hemodynamic parameters after PCT, with a significant reduction of mean pulmonary artery pressure before and after PCT (40 +/- 13 mmHg vs. 25 +/- 12 mmHg, p < 0.001, figure 1), as well as an improvement in systolic blood pressure (102 +/- 13 mmHg vs. 129 +/- 14, p < 0.001) and the partial pressure of oxygen (51 +/- 3 vs. 67 +/- 2, p = 0.002). We also observed a significant decrease in NT-proBNP values at admission and 48 hours after PCT (4791 +/- 1077 pg/mL vs. 2311 +/- 680 pg/mL, p = 0.002, figure 2), as well as an improvement in echocardiographic right ventricular function parameters evaluated at admission and 72 hours after PCT, such as TAPSE (15 +/- 2 mm vs 22 +/- 3 mm, p = 0.001) or right ventricle basal diameter (51 +/- 4 mm vs. 41 +/- 2 mm, p = 0.001). During a median follow-up of 7 months (4 - 12 months) one patient died of non-cardiac cause and none of them had a major or minor bleeding event. Conclusion PCT in patients with HIRPE with hemodynamic deterioration on anticoagulation is a simple and effective procedure with an immediate reduction of mean pulmonary pressure and an early improvement of right ventricle-related biochemical, hemodynamic and echocardiographic parameters. Abstract Figure 1: mPAP after and before PCT.

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