Abstract:
OBJECTIVE:On hospital admission, the morphology of the central pulmonary artery thromboemboli is an independent predictor of 30-day mortality in patients with massive pulmonary embolism (MPE). This may be due to the differential susceptibility of thromboemboli to thrombolysis. The aim of this study was to assess haemodynamic response to treatment in patients with MPE and morphologically different thromboemboli. DESIGN:Prospective observational study. SETTING:An 11-bed closed medical ICU at a 860-bed community general hospital. PATIENTS:Twelve consecutive patients with shock or hypotension due to MPE and central pulmonary thromboemboli detected by transesophageal echocardiography who were treated with thrombolysis between January 2000 through April 2002. PROCEDURES:Patients were divided into two groups according to the characteristics of detected central pulmonary thromboemboli: group 1, thrombi with one or more long, mobile parts; and group 2, immobile thrombi. Urokinase infusion was terminated when mixed venous oxygen saturation was stabilized above 60% for 15 min. RESULTS:At 2 h, the total pulmonary vascular resistance index was reduced more in group 1 than group 2 [from 27+/-12 mmHg/(l.min.m(2)) to 14+/-6 mmHg/(l.min.m(2)) (-52%) vs 27+/-8 mmHg/(l.min.m(2)) to 23+/-10 mmHg/(l.min.m(2)) (-15%), respectively, P=0.04]. In group 1 thrombolysis was terminated earlier than group 2 (89+/-40 min vs 210+/-62 min, respectively, P= 0.0024). The cumulative dose of urokinase used in group 1 was lower than group 2 (1.7+/-0.3 M i.u. vs 2.7+/-0.5 M i.u., respectively, P= 0.023). CONCLUSION:Haemodynamic stabilization is achieved faster in patients with mobile central thromboemboli detected by transesophageal echocardiography during MPE.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Podbregar M,Voga G,Krivec Bdoi
10.1007/s00134-004-2314-5keywords:
subject
Has Abstractpub_date
2004-08-01 00:00:00pages
1552-6issue
8eissn
0342-4642issn
1432-1238journal_volume
30pub_type
杂志文章abstract::Owing to an oversight by the authors, Figure 2 in this article was not the version intended for publication. The correct Figure 2, reproduced here, features footnote symbols and Figure 2b includes three studies as described in the main text. ...
journal_title:Intensive care medicine
pub_type: 杂志文章,已发布勘误
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abstract:OBJECTIVE:We examined in rabbits the effects of more than 48 h of mechanical ventilation on the contractile properties and fiber type adaptations of the respiratory muscles. DESIGN AND SETTING:Experimental prospective study in a university laboratory. ANIMALS AND INTERVENTIONS:Nineteen rabbits were randomly allocated...
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journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2001-10-01 00:00:00
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更新日期:2011-03-01 00:00:00
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