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TROMBOEMBOLISMO PULMONAR AGUDO

Major pulmonary embolism: review of a pathophysiologic approach to the golden hour of hemodynamically significant pulmonary embolism. Chest 2002;121;877–905. TROMBOEMBOLISMO PULMONAR AGUDO. DIEGO FERNANDO BAUTISTA R. INTERNISTA INTENSIVISTA UNIVERSIDAD DEL CAUCA-UNIVERSIDAD DEL VALLE.

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TROMBOEMBOLISMO PULMONAR AGUDO

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  1. Major pulmonary embolism: review of a pathophysiologic approach to the golden hour of hemodynamically significant pulmonary embolism. Chest 2002;121;877–905

  2. TROMBOEMBOLISMO PULMONAR AGUDO DIEGO FERNANDO BAUTISTA R. INTERNISTA INTENSIVISTA UNIVERSIDAD DEL CAUCA-UNIVERSIDAD DEL VALLE

  3. Major pulmonary embolism: review of a pathophysiologic approach to the golden hour of hemodynamically significant pulmonary embolism. Chest 2002;121;877–905

  4. Major pulmonary embolism: review of a pathophysiologic approach to the golden hour of hemodynamically significant pulmonary embolism. Chest 2002;121;877–905

  5. Major pulmonary embolism: review of a pathophysiologic approach to the golden hour of hemodynamically significant pulmonary embolism. Chest 2002;121;877–905

  6. Crit Care Clin 27 (2011) 841–867

  7. Ferrari E, Imbert A, Chevalier T, et al. The ECG in pulmonary embolism. Predictive value of negative T waves in precordial leads—80 case reports. Chest 1997;111(3):537–43.

  8. Paul D. Stein, et al.Gadolinium-Enhanced Magnetic Resonance Angiography for Pulmonary Embolism A Multicenter Prospective Study (PIOPED III).Ann Intern Med. 2010;152:434-443.

  9. Paul D. Stein, et al.Gadolinium-Enhanced Magnetic Resonance Angiography for Pulmonary Embolism A Multicenter Prospective Study (PIOPED III).Ann Intern Med. 2010;152:434-443.

  10. Philip S. Wells, MD.JAMA. 2007;298(23):2743-2753

  11. JAMA. 2006;295:172-179

  12. Chest 2002;121;877–905

  13. Crit Care Clin 27 (2011) 953–967

  14. STAVROS KONSTANTINIDES et al, HEPARIN PLUS ALTEPLASE COMPARED WITH HEPARIN ALONE IN PATIENTS WITH SUBMASSIVE PULMONARY EMBOLISM. N Engl J Med, Vol. 347, No. 15·October 10, 2002

  15. STAVROS KONSTANTINIDES et al, HEPARIN PLUS ALTEPLASE COMPARED WITH HEPARIN ALONE IN PATIENTS WITH SUBMASSIVE PULMONARY EMBOLISM. N Engl J Med, Vol. 347, No. 15·October 10, 2002

  16. Olivier Sanchez, et al. Prognostic Factors for Pulmonary Embolism The PREP Study, A Prospective Multicenter Cohort Study. Am J Respir Crit Care Med Vol 181. pp 168–173, 2010

  17. Olivier Sanchez, et al. Prognostic Factors for Pulmonary Embolism The PREP Study, A Prospective Multicenter Cohort Study. Am J Respir Crit Care Med Vol 181. pp 168–173, 2010

  18. Olivier Sanchez, et al. Prognostic Factors for Pulmonary Embolism The PREP Study, A Prospective Multicenter Cohort Study. Am J Respir Crit Care Med Vol 181. pp 168–173, 2010

  19. Olivier Sanchez, et al. Prognostic Factors for Pulmonary Embolism The PREP Study, A Prospective Multicenter Cohort Study. Am J Respir Crit Care Med Vol 181. pp 168–173, 2010

  20. Crit Care Clin 27 (2011) 953–967

  21. BACKGROUND: In acute pulmonary embolism (PE), overt right ventricular (RV) failure with cardiogenic shock indicates a poor prognosis. However, normotensive patients with acute RV dysfunction on echocardiography or computed tomography and with myocardial troponin elevation may also have an adverse outcome. Thrombolysis rapidly reverses RV pressure overload in PE, but it remains unclear whether it may improve the early and long-term clinical outcome of selected normotensive patients. DESIGN: The Pulmonary EmbolIsm THrOmbolysis (PEITHO) trial is a prospective, multicenter, international, randomized (1:1), double-blind comparison of thrombolysis with tenecteplase vs placebo in normotensive patients with confirmed PE, an abnormal right ventricle on echocardiography or computed tomography, and a positive troponin I or T test result. Both treatment groups receive standard anticoagulation. The primary efficacy outcome is the composite of death from any cause or hemodynamic collapse within 7 days of randomization. Safety outcomes include ischemic/hemorrhagic strokes and other major bleeding episodes. In addition, 180-day clinical and echocardiographic follow-up will be performed. The study is expected to enroll approximately 1,000 patients. CONCLUSIONS: By determining the benefits vs risks of thrombolysis in submassive or intermediate-risk PE, this trial is expected to answer a long-standing query on the management of this patient population.

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