Update on Perioperative Pulmonary Embolism Management: A Decision Support Tool to Aid in Diagnosis and Treatment

Alan M Smeltz; Lavinia M Kolarczyk; Robert S Isaak

doi:10.1016/j.aan.2017.08.001

Update on Perioperative Pulmonary Embolism Management: A Decision Support Tool to Aid in Diagnosis and Treatment

Adv Anesth. 2017;35(1):213-228. doi: 10.1016/j.aan.2017.08.001.

Authors

Alan M Smeltz¹, Lavinia M Kolarczyk¹, Robert S Isaak²

Affiliations

¹ Department of Anesthesiology, University of North Carolina at Chapel Hill School of Medicine, N2198 UNC Hospitals, CB 7010, Chapel Hill, NC 27599, USA.
² Department of Anesthesiology, University of North Carolina at Chapel Hill School of Medicine, N2198 UNC Hospitals, CB 7010, Chapel Hill, NC 27599, USA. Electronic address: RIsaak@aims.unc.edu.

PMID: 29103574
DOI: 10.1016/j.aan.2017.08.001

Abstract

Pulmonary embolism (PE) affects up to 1 in every 1000 people per year, one-third of whom do not survive. Moreover, perioperative presentation of PE is 5 times more likely than at other times and poses a unique set of challenges for both diagnosis and treatment. This article discusses several important aspects regarding the prevention, diagnosis, and management of perioperative PE, incorporating information from the most recent practice guidelines, emerging literature on medical therapy, and interventional therapies. It proposes a clinical decision support tool that organizes the salient aspects of perioperative PE management to serve as an aid in practice.

Keywords: Anticoagulation; Perioperative management; Pulmonary embolism; Thrombolysis; Transesophageal echocardiography.

Publication types

Review

MeSH terms

Decision Support Techniques*
Humans
Perioperative Care / methods*
Practice Guidelines as Topic
Pulmonary Embolism / diagnosis*
Pulmonary Embolism / etiology
Pulmonary Embolism / therapy
Risk Factors
Thrombolytic Therapy / methods