The management of pulmonary embolism

Pulmonary embolism (PE) is a significant cause of hospitalization, morbidity and mortality, frequently requiring critical care services. Critically ill patients are also at increased risk of developing venous thromboembolism (VTE) and acute PE. Critical care clinicians should therefore be confident in their approach to the patient with suspected and diagnosed PE. Furthermore, the co-morbid conditions in this patient group may present additional challenges both in diagnosis (e.g. safe access to radiology) and management (e.g. absolute and relative contraindications to anticoagulation/thrombolysis in critically ill patients). This brief review summarizes the evidence base behind current diagnostic and treatment strategies and draws upon this to suggest a simple algorithm for the management of patients with suspected or confirmed PE, particularly tailored to patients within a critical care setting.

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