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Rebuttal From Dr JiménezRebuttal From Dr Jiménez

David Jiménez, MD, PhD
Author and Funding Information

From the Respiratory Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria.

Correspondence to: David Jiménez, MD, PhD, Respiratory Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain; e-mail: djc_69_98@yahoo.com


Financial/nonfinancial disclosures: The author has reported to CHEST the following conflict of interest: Dr Jiménez is a member of the Steering Committee of the Pulmonary Embolism International Thrombolysis Trial.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(2):302-303. doi:10.1378/chest.12-2448
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Extract

My colleagues Drs Bilello and Murin1 contend that thrombolytics should not be used for submassive pulmonary embolism (PE) using two arguments: (1) Studies have not demonstrated a survival benefit from thrombolysis in patients with acute submassive PE, and (2) studies have not validated an explicit prediction rule for identifying the subgroup of normotensive patients with PE who are at high risk of PE-related complications, in contrast to hemodynamically unstable patients “based upon their high mortality rate and the physiologic rationale that they should benefit from the more rapid dissolution of the clot, and resultant relief of vascular obstruction….”1

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