Author/Editor		Trpin, Eva; Fabjan, Andrej
Title		Napovedni dejavniki pri bolnikih z obsežno pljučno embolijo
Type		monografija
Place		Ljubljana
Publisher		Univerza v Ljubljani, Medicinska fakulteta
Publication year		2004
Volume		str. 34
Language		slo
Abstract		BACKGROUND. Pulmonary thromboembolism (PE) is lifethreatening, potentially curable disease. Treatment can be either nonaggressive (anticoagulation) or aggressive (thrombolysis, catheter thrombus aspiration/fragmentation, surgical embolectomy). Hypotension, concomittant illnesses and acute right ventricular dysfunction are negative prognostic factors. Haemodinamically instable patient with hypotension are treated aggressively. The use of thrombolysis in normotensive patients with right ventricular dysfunction remains controversial. The influence of the prognostic factors on the course of the disease has not been evaluated in Slovenia. There are also no data collected on the outcome of the selected treatment. AIM. Some of the basic data available to the doctor soon after admission were included as prognostic factors: concomittant illnesses, syncope, hypotension, tachycardia, tachypnoa, hypoxemia, hypocapnia, increased cardiac troponin concentration and echocardiographic signs of right-ventricular dysfunction. Our aim is to evaluate the influence of prognostic factors on the choice of the treatment and their relation to mortality and adverse outcome (cardiopulmonary resuscitation in the intensive care unit, the need for artificial respiration, the need for vasopressors or positive inotropic drugs, additional thrombolysis, prolonged intensive care unit treatment, reccurence of PE). We are also trying to evaluate the benefits of aggressive treatment in patients with prognostic factors. HYPOTHESIS. The choice of aggressive treatment is related to the presence of prognostic factors in patients with PE treated in intensive care unit. Mortality and adverse outcome are more common in patients with prognostic factors than in those without. Patients with prognostic factors treated aggressively have lower mortality and incidence of adverse outcome than those treated nonaggressively. (Abstract truncated at 2000 characters).
Descriptors		PULMONARY EMBOLISM INTENSIVE CARE UNITS SYNCOPE HYPOTENSION VENTRICULAR DYSFUNCTION, RIGHT TACHYCARDIA HYPOCAPNIA TROPONIN PROGNOSIS