Authors: Queluz, Thais T.; Bok Yoo, Hugo H.y.u.n.g.; Rodrigues, Haroldo

Source: Current Respiratory Medicine Reviews, Volume 4, Number 1, February 2008 , pp. 52-56(5)

Publisher: Bentham Science Publishers

Abstract:

Pulmonary thromboembolism (PTE) ranges from incidental, clinically unimportant thromboembolism to massive embolism with sudden death. Its treatment is well established in two groups of patients: heparin for those with normal systemic blood pressure without right ventricular dysfunction (RVD) and thrombolysis for those with RVD and circulatory shock. In an intermediate group of patients with systemic blood pressure stability combined with RVD, which is usually associated with worse outcome, the treatment is controversial. There are authors who strongly suggest thrombolysis while others contraindicate this procedure and recommend anticoagulation with heparin.

This is a narrative review that includes clinical trials comparing thrombolysis and heparin for the treatment of PTE patients with systemic blood pressure stability and RVD published since 1973.

The results show that there are only four trials on this subject with less than 500 patients. Many PTE patients with systemic blood pressure stability and RVD might benefit from thrombolysis but, on the other hand, the risk for hemorrhagic events may be increased. Large randomized clinical trials are required to clarify this.

Keywords: Systemic blood pressure; pulmonary thromboembolism; right ventricular dysfunction; treatment; thrombolysis

Document Type: Research article

DOI: http://dx.doi.org/10.2174/157339808783497828

Publication date: 2008-02-01

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• Current Respiratory Medicine Reviews publishes frontier reviews on all the latest advances on respiratory diseases and its related areas e.g. pharmacology, pathogenesis, clinical care, and therapy. The journal's aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all researchers and clinicians in respiratory medicine.

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