Pulmonary Embolism ABG Question
Sorry in advanced if this is a stupid question. I've been trying to figure out why a PE is considered respiratory alkalosis. I thought it would be a metabolic acidosis with respiratory compensation. Isn't the mechanism for a pulmonary embolism: PE -> decrease PO2 -> lactic acid generation(metabolic acidosis) -> tachypnea (respiratory compensation) I would appreciate any help on what I am missing. This has really been nagging at me today.
Guidelines-recommend thrombolytic therapy for pulmonary embolism in patients with severe hemodynamic compromise and low risk of bleeding. Thrombolytics in submassive pulmonary embolism have an unfavorable risk/benefit ratio and remain controversial. Based on our experience with extensive, lower extremity thrombi, nine patients with symptomatic, submassive pulmonary embolisms (five medical, four surgical) were treated with low-dose alteplase (
We report a novel case of LAHS in which the patient experienced the sequence of hemorrhage–thrombosis–hemorrhage before eventually dying of fatal pulmonary embolism and pulmonary hemorrhage. Specifically, she presented with multiple gastrointestinal bleeding episodes, followed by multifocal subdural hematomas, pulmonary embolism after normalization of prothrombin activity levels with immunosuppression, and finally with fatal pulmonary hemorrhage after enoxaparin treatment for pulmonary embolism. This case illustrates the importance of recognizing early minor bleeding episodes, and detecting specific antiprothro...
ConclusionsVTE after pediatric trauma is rare, and may be more uncommon than previously reported. CVC placement was the strongest predictor of VTE, particularly in infant and toddler patients which can explain their higher overall incidence compared to other pediatric age groups. Identifying high-risk patients is important to optimize screening and prophylaxis of VTE in pediatric trauma patients while minimizing risks of anticoagulation.
Publication date: December 2018Source: Annals of Emergency Medicine, Volume 72, Issue 6Author(s): Tyler W. Barrett, Clifford L. Freeman
No abstract available
In this study of admissions for acute PE, comorbid cancer was associated with decreased odds of receiving thrombolysis. As PE is a common complication among patients with cancer, the risk–benefit profile of thrombolysis in this patient population should be determined.
Conclusion For multiple small lung pulmonary nodules requiring thoracoscopic surgery, according to certain strategies, preoperative CT-guided localized by microcoil in batches according to priority before VATS is safe and effective, and worthy of pr omotion. DOI: 10.3779/j.issn.1009-3419.2018.11.08
Venous thromboembolism remains a common cause of direct maternal deaths in high-income settings such as the United Kingdom. Pregnancy alone increases the risk of deep vein thrombosis and pulmonary embolus at least five-fold, and many women develop or have additional risk factors for venous thrombosis during pregnancy and the puerperium, the latter representing the period of highest risk. Early and repeated risk stratification and adequate thromboprophylaxis, usually with low molecular weight heparin, is the key to preventing venous thromboembolism (VTE).
AbstractPurposeThe aim of this study is to assess the feasibility of aspiration mechanical thrombectomy in patients with massive and submassive pulmonary embolism (PE) and contraindications to thrombolysis.Materials and MethodsEighteen patients presenting massive (8/18) or submassive (10/18) PE were prospectively enrolled between October 2016 and November 2017. All the patients enrolled had contraindications to thrombolysis (haemorrhagic stroken = 1, ischaemic stroke in the preceding 6 monthsn = 7, central nervous system damage or neoplasmsn = 1, recent major trauma/surgery/he...