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PULMONARY EMBOLISM IN ICU PATIENTS

Ali breek Alharthi , Fahad Abdullah Alshehri , Aisha Omar Aljiffry , Mohammed Nasr Al Yaquob , Alaa Matuq Alaithan , Mashail Hashim Farran , Saleh Sameer Ashgar , Ahmed Ibrahim Alkhawaji , Udai Othman Alghanmi ,Fatimah Nader Al Jishi,

Introduction: Pulmonary embolism is a serious condition that, in some cases, can be fatal and lead to significant complications or mortality. A major pulmonary embolism generally manifests with rapid right ventricle failure along with severe hypoxia. The changes in pressure of the right ventricle are usually related to both the mechanical changes resulting from the vessels obstruction and the presence of abnormal cardiopulmonary condition. Management of pulmonary embolism must start as soon as possible, especially when dealing with patients with critical conditions, who must be immediately moved to the intensive care unit Aim of work: In this review, we will discuss the most recent evidence regarding the management strategies for high-risk PE in recent years. Methodology: We did a systematic search for the most recent evidence regarding the management strategies for high-risk PE in recent years using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). Our search also looked for the pathophysiology and prevention. All relevant studies were retrieved and discussed. We only included full articles. Conclusions: Pulmonary embolism is an emergent condition that can be serious and life threatening. Diagnosis of pulmonary embolism can be confirmed using CT angiography, or echocardiograph. However, in high-risk patients, treatment should be immediately started without waiting for test results. Anticoagulation agents are the main line of treatment, and unfractionated heparin must be administrated as early as possible. Some studies have found benefits associated with the use of thrombolytics therapy. However, this should be applied with caution to prevent the development of associated complication, which can be fatal in some cases. Inferior vena cave filters are used when there is recurrence of pulmonary embolism or in patients who fail to achieve sufficient anticoagulation despite full treatment. These have been found to significantly improve mortality and recurrence of the disease, but do not provide treatment for the underlying DVT. Further studies are required to improve pulmonary embolism management and treatment protocols Key words: Pulmonary embolism, DVT, critical patient, ICU, Management.

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