Cite this post as:
Scott Weingart, MD FCCM. Podcast 128 – Pulmonary Embolism Treatment Options and the PEAC Team with Oren Friedman. EMCrit Blog. Published on July 14, 2014. Accessed on March 24th 2023. Available at [https://emcrit.org/emcrit/pulmonary-embolism-treatment-team/ ].
Dr. Scott Weingart, Course Director, reports no relevant financial relationships with ineligible companies.
This episode’s speaker(s), (listed above), report no relevant financial relationships with ineligible companies.
Original Release: July 14, 2014
Date of Most Recent Review: Jan 1, 2022
Termination Date: Jan 1, 2025
You finished the 'cast,
Now Join EMCrit!
As a member, you can...
- Get CME hours
- Get the On Deeper Reflection Podcast
- Support the show
- Write it off on your taxes or get reimbursed by your department
Get the EMCrit Newsletter
If you enjoyed this post, you will almost certainly enjoy our others. Subscribe to our email list to keep informed on all of the Resuscitation and Critical Care goodness.
This Post was by the EMCrit Crew, published 9 years ago. We never spam; we hate spammers! Spammers probably work for the Joint Commission.
Scott, Great podcast as always. Part of the problem is what do we mean by “submassive PE”? There is obviously a spectrum of disease. I’d be very hard pressed to lyse the patient who meets the definition by cardiac enzymes or BNP but otherwise looks great and has a slightly abnormal RV. Furthermore, three trials have now shown that thrombolysis does not reduce short term mortality. PEITHO, by far the largest trial ever done, clearly demonstrated that standard dose tenecteplase (100 mg), made people bleed. Hard to argue with a 10x increase in head bleeds in the treatment arm. There… Read more »
I watched Dr. Friedman’s lecture on emedhome.com and thought it was great. My question is the distinction between catheter directed thrombolysis and ultrasound assisted thrombolysis for acute PE. Do both require 15 hr infusions of tpa at his institution or does CDT mean squirting the TPA while macerating the clot as opposed to a prolonged infusion? I ask because it seems to me that if the PA pressure is very high, then a prolonged infusion would be less desirable versus opening up the clot ASAP to get the PA pressure down. Thanks so much for posting the neuroconference lectures online.… Read more »
both techniques use prolonged infusions. the doses delivered directly into the clot should provide same speed of resolution (at least) as the big systemic dose (especially when they give a bolus up front)
For your example of the young patient after 30+ hr plane trip and submissive PE with hypoxia, would you recommend transfer to a hospital with IR, if this patient comes to a community hospital without Interventional Radiology? If so, would you transfer him on a heparin drip?
In the well and stable sub-massive PE do you ever use lovenox instead of heparin? Why or why not?
Thanks for your help.