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Editorials |

When Pulmonary Embolism Treatment Isn’t Working

Bruce Davidson, MD, MPH, FCCP; Riyad Karmy-Jones, MD
Author and Funding Information

Affiliations: Seattle, Washington
 ,  Dr. Davidson is affiliated with the Pulmonary-Critical Care Medicine Division, University of Washington and Swedish Medical Centers. Dr. Karmy-Jones is affiliated with the Cardiothoracic and Trauma Surgery Divisions, University of Washington and Harborview Medical Centers.

Correspondence to: Bruce Davidson, MD, MPH, FCCP, 801 Broadway, Suite 915, Seattle, WA 98122; email: brucedavidson@pobox.com



Chest. 2006;129(4):839-840. doi:10.1378/chest.129.4.839
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Extract

Objectively proven acute pulmonary embolism (PE) is a satisfying disease to treat—unless the treatment isn’t working. Supplementary oxygen for the ventilation-perfusion component of hypoxia, urgent anticoagulation IV or subcutaneously, and intensive care for patients with more profound abnormalities are relatively easily accomplished. Intensive care may include IV, peripherally administered thrombolysis (absent a serious or absolute contraindication) and IV crystalloid and pressor, with careful attention to right ventricular filling, titrated to support cardiac output.


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