Multidisciplinary Consensus for the Management of Pulmonary Thromboembolism

We have updated recommendations on 12 controversial topics that were published in the 2013 National Consensus on the diagnosis, risk stratification and treatment of patients with pulmonary embolism (PE). A comprehensive review of the literature was performed for each topic, and each recommendation w...

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Autores: Lobo, JL, Alonso, S, Arenas, J, Domenech, P, Escribano, P, Fernandez-Capitan, C, Jara-Palomares, L, Jimenez, S, Lazaro, M, Lecumberri, R, Monreal, M, Ruiz-Artacho, P, Jimenez, D
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p9157
Acceso en línea:https://isabial.portalinvestigacion.com/publicaciones9157
Access Level:acceso abierto
Palabra clave:Pulmonary embolism
Diagnosis
Prognosis
Treatment
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spelling Multidisciplinary Consensus for the Management of Pulmonary ThromboembolismLobo, JLAlonso, SArenas, JDomenech, PEscribano, PFernandez-Capitan, CJara-Palomares, LJimenez, SLazaro, MLecumberri, RMonreal, MRuiz-Artacho, PJimenez, DPulmonary embolismDiagnosisPrognosisTreatmentWe have updated recommendations on 12 controversial topics that were published in the 2013 National Consensus on the diagnosis, risk stratification and treatment of patients with pulmonary embolism (PE). A comprehensive review of the literature was performed for each topic, and each recommendation was evaluated in two teleconferences. For diagnosis, we recommend against using the Pulmonary Embolism Rule Out Criteria (PERC) rule as the only test to rule out PE, and we recommend using a D-dimer cutoff adjusted to age to rule out PE. We suggest using computed tomography pulmonary angiogram as the imaging test of choice for the majority of patients with suspected PE. We recommend using direct oral anticoagulants (over vitamin K antagonists) for the vast majority of patients with acute PE, and we suggest using anticoagulation for patients with isolated subsegmental PE. We recommend against inserting an inferior cava filter for the majority of patients with PE, and we recommend using full-dose systemic thrombolytic therapy for PE patients requiring reperfusion. The decision to stop anticoagulants at 3 months or to treat indefinitely mainly depends on the presence (or absence) and type of risk factor for venous thromboembolism, and we recommend against thrombophilia testing to decide duration of anticoagulation. Finally, we suggest against extensive screening for occult cancer in patients with PE. (C) 2021 SEPAR. Published by Elsevier Espana, S.L.U. All rights reserved.ELSEVIER ESPANA SLU2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones9157ARCHIVOS DE BRONCONEUMOLOGIAISSN: 03002896ISSNe: 15792129reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p91572026-06-12T10:20:37Z
dc.title.none.fl_str_mv Multidisciplinary Consensus for the Management of Pulmonary Thromboembolism
title Multidisciplinary Consensus for the Management of Pulmonary Thromboembolism
spellingShingle Multidisciplinary Consensus for the Management of Pulmonary Thromboembolism
Lobo, JL
Pulmonary embolism
Diagnosis
Prognosis
Treatment
title_short Multidisciplinary Consensus for the Management of Pulmonary Thromboembolism
title_full Multidisciplinary Consensus for the Management of Pulmonary Thromboembolism
title_fullStr Multidisciplinary Consensus for the Management of Pulmonary Thromboembolism
title_full_unstemmed Multidisciplinary Consensus for the Management of Pulmonary Thromboembolism
title_sort Multidisciplinary Consensus for the Management of Pulmonary Thromboembolism
dc.creator.none.fl_str_mv Lobo, JL
Alonso, S
Arenas, J
Domenech, P
Escribano, P
Fernandez-Capitan, C
Jara-Palomares, L
Jimenez, S
Lazaro, M
Lecumberri, R
Monreal, M
Ruiz-Artacho, P
Jimenez, D
author Lobo, JL
author_facet Lobo, JL
Alonso, S
Arenas, J
Domenech, P
Escribano, P
Fernandez-Capitan, C
Jara-Palomares, L
Jimenez, S
Lazaro, M
Lecumberri, R
Monreal, M
Ruiz-Artacho, P
Jimenez, D
author_role author
author2 Alonso, S
Arenas, J
Domenech, P
Escribano, P
Fernandez-Capitan, C
Jara-Palomares, L
Jimenez, S
Lazaro, M
Lecumberri, R
Monreal, M
Ruiz-Artacho, P
Jimenez, D
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Pulmonary embolism
Diagnosis
Prognosis
Treatment
topic Pulmonary embolism
Diagnosis
Prognosis
Treatment
description We have updated recommendations on 12 controversial topics that were published in the 2013 National Consensus on the diagnosis, risk stratification and treatment of patients with pulmonary embolism (PE). A comprehensive review of the literature was performed for each topic, and each recommendation was evaluated in two teleconferences. For diagnosis, we recommend against using the Pulmonary Embolism Rule Out Criteria (PERC) rule as the only test to rule out PE, and we recommend using a D-dimer cutoff adjusted to age to rule out PE. We suggest using computed tomography pulmonary angiogram as the imaging test of choice for the majority of patients with suspected PE. We recommend using direct oral anticoagulants (over vitamin K antagonists) for the vast majority of patients with acute PE, and we suggest using anticoagulation for patients with isolated subsegmental PE. We recommend against inserting an inferior cava filter for the majority of patients with PE, and we recommend using full-dose systemic thrombolytic therapy for PE patients requiring reperfusion. The decision to stop anticoagulants at 3 months or to treat indefinitely mainly depends on the presence (or absence) and type of risk factor for venous thromboembolism, and we recommend against thrombophilia testing to decide duration of anticoagulation. Finally, we suggest against extensive screening for occult cancer in patients with PE. (C) 2021 SEPAR. Published by Elsevier Espana, S.L.U. All rights reserved.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://isabial.portalinvestigacion.com/publicaciones9157
url https://isabial.portalinvestigacion.com/publicaciones9157
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER ESPANA SLU
publisher.none.fl_str_mv ELSEVIER ESPANA SLU
dc.source.none.fl_str_mv ARCHIVOS DE BRONCONEUMOLOGIA
ISSN: 03002896
ISSNe: 15792129
reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
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