Hemodynamic and respiratory support in pulmonary embolism: a narrative review
Pulmonary embolism is a common and potentially fatal disease, with a significant burden on health and survival. Right ventricular dysfunction and hemodynamic instability are considered two key determinants of mortality in pulmonary embolism, which can reach up to 65% in severe cases. Therefore, time...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-06-01
|
| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1123793/full |
| _version_ | 1797813574779797504 |
|---|---|
| author | Orlando Rubén Pérez-Nieto Irene Gómez-Oropeza Andrés Quintero-Leyra Ashuin Kammar-García Éder Iván Zamarrón-López Maximiliano Soto-Estrada Luis Antonio Morgado-Villaseñor Héctor David Meza-Comparán |
| author_facet | Orlando Rubén Pérez-Nieto Irene Gómez-Oropeza Andrés Quintero-Leyra Ashuin Kammar-García Éder Iván Zamarrón-López Maximiliano Soto-Estrada Luis Antonio Morgado-Villaseñor Héctor David Meza-Comparán |
| author_sort | Orlando Rubén Pérez-Nieto |
| collection | DOAJ |
| description | Pulmonary embolism is a common and potentially fatal disease, with a significant burden on health and survival. Right ventricular dysfunction and hemodynamic instability are considered two key determinants of mortality in pulmonary embolism, which can reach up to 65% in severe cases. Therefore, timely diagnosis and management are of paramount importance to ensure the best quality of care. However, hemodynamic and respiratory support, both major constituents of management in pulmonary embolism, associated with cardiogenic shock or cardiac arrest, have been given little attention in recent years, in favor of other novel advances such as systemic thrombolysis or direct oral anticoagulants. Moreover, it has been implied that current recommendations regarding this supportive care lack enough robustness, further complicating the problem. In this review, we critically discuss and summarize the current literature concerning the hemodynamic and respiratory support in pulmonary embolism, including fluid therapy, diuretics, pharmacological support with vasopressors, inotropes and vasodilators, oxygen therapy and ventilation, and mechanical circulatory support with veno-arterial extracorporeal membrane oxygenation and right ventricular assist devices, while also providing some insights into contemporary research gaps. |
| first_indexed | 2024-03-13T07:54:46Z |
| format | Article |
| id | doaj.art-1cd86edaf00540cb9a8fab8689a34033 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-13T07:54:46Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-1cd86edaf00540cb9a8fab8689a340332023-06-02T06:08:30ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-06-011010.3389/fmed.2023.11237931123793Hemodynamic and respiratory support in pulmonary embolism: a narrative reviewOrlando Rubén Pérez-Nieto0Irene Gómez-Oropeza1Andrés Quintero-Leyra2Ashuin Kammar-García3Éder Iván Zamarrón-López4Maximiliano Soto-Estrada5Luis Antonio Morgado-Villaseñor6Héctor David Meza-Comparán7Unidad de Cuidados Intensivos, Hospital General San Juan del Río, Querétaro, MexicoDepartment of Health Science, Universidad de las Américas Puebla, San Andrés Cholula, Puebla, MexicoCoordinación Estatal de Capacitación, Mexican Red Cross, Estado de México, MexicoDirección de Investigación, Instituto Nacional de Geriatría, Mexico City, MexicoUnidad de Cuidados Intensivos, Hospital MAC Tampico, Tampico, Tamaulipas, MexicoDepartamento de Emergencias, Hospital General de Zona 11 IMSS Delicias, Delicias, Chihuahua, MexicoUnidad de Cuidados Intensivos, Hospital Christus Muguerza, Reynosa, Tamaulipas, MexicoDirección de Investigación, Instituto Nacional de Geriatría, Mexico City, MexicoPulmonary embolism is a common and potentially fatal disease, with a significant burden on health and survival. Right ventricular dysfunction and hemodynamic instability are considered two key determinants of mortality in pulmonary embolism, which can reach up to 65% in severe cases. Therefore, timely diagnosis and management are of paramount importance to ensure the best quality of care. However, hemodynamic and respiratory support, both major constituents of management in pulmonary embolism, associated with cardiogenic shock or cardiac arrest, have been given little attention in recent years, in favor of other novel advances such as systemic thrombolysis or direct oral anticoagulants. Moreover, it has been implied that current recommendations regarding this supportive care lack enough robustness, further complicating the problem. In this review, we critically discuss and summarize the current literature concerning the hemodynamic and respiratory support in pulmonary embolism, including fluid therapy, diuretics, pharmacological support with vasopressors, inotropes and vasodilators, oxygen therapy and ventilation, and mechanical circulatory support with veno-arterial extracorporeal membrane oxygenation and right ventricular assist devices, while also providing some insights into contemporary research gaps.https://www.frontiersin.org/articles/10.3389/fmed.2023.1123793/fullpulmonary embolismrespiratory therapyoxygen inhalation therapyfluid therapydiureticsvasoconstrictor agents |
| spellingShingle | Orlando Rubén Pérez-Nieto Irene Gómez-Oropeza Andrés Quintero-Leyra Ashuin Kammar-García Éder Iván Zamarrón-López Maximiliano Soto-Estrada Luis Antonio Morgado-Villaseñor Héctor David Meza-Comparán Hemodynamic and respiratory support in pulmonary embolism: a narrative review Frontiers in Medicine pulmonary embolism respiratory therapy oxygen inhalation therapy fluid therapy diuretics vasoconstrictor agents |
| title | Hemodynamic and respiratory support in pulmonary embolism: a narrative review |
| title_full | Hemodynamic and respiratory support in pulmonary embolism: a narrative review |
| title_fullStr | Hemodynamic and respiratory support in pulmonary embolism: a narrative review |
| title_full_unstemmed | Hemodynamic and respiratory support in pulmonary embolism: a narrative review |
| title_short | Hemodynamic and respiratory support in pulmonary embolism: a narrative review |
| title_sort | hemodynamic and respiratory support in pulmonary embolism a narrative review |
| topic | pulmonary embolism respiratory therapy oxygen inhalation therapy fluid therapy diuretics vasoconstrictor agents |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1123793/full |
| work_keys_str_mv | AT orlandorubenpereznieto hemodynamicandrespiratorysupportinpulmonaryembolismanarrativereview AT irenegomezoropeza hemodynamicandrespiratorysupportinpulmonaryembolismanarrativereview AT andresquinteroleyra hemodynamicandrespiratorysupportinpulmonaryembolismanarrativereview AT ashuinkammargarcia hemodynamicandrespiratorysupportinpulmonaryembolismanarrativereview AT ederivanzamarronlopez hemodynamicandrespiratorysupportinpulmonaryembolismanarrativereview AT maximilianosotoestrada hemodynamicandrespiratorysupportinpulmonaryembolismanarrativereview AT luisantoniomorgadovillasenor hemodynamicandrespiratorysupportinpulmonaryembolismanarrativereview AT hectordavidmezacomparan hemodynamicandrespiratorysupportinpulmonaryembolismanarrativereview |