{"version":"1.0","type":"rich","provider_name":"Acast","provider_url":"https://acast.com","height":250,"width":700,"html":"<iframe src=\"https://embed.acast.com/$/649181182c969b001128353f/67020fea0aa98133a3416de5?\" frameBorder=\"0\" width=\"700\" height=\"250\"></iframe>","title":"35. Pulmonary Embolism Masterclass with Dr. Rich Channick","thumbnail_width":200,"thumbnail_height":200,"thumbnail_url":"https://open-images.acast.com/shows/649181182c969b001128353f/1728187963395-02d84d67-c8ee-4b78-bb1e-de59e7b3935b.jpeg?height=200","description":"<p>On this week's release, Cyrus and Nick revisit one of their favorite topics: Pulmonary Embolism! In this episode - a follow up to our two-parter from season 1 - we sit down with Dr. Rick Channick of UCLA to talk about his approach to PE management with a focus on catheter directed therapies &amp; PE response teams. This episode is packed full of expert insights and practical clinical pearls. Give it a listen and let us know what you think!</p><p><br></p><p><strong>Risk Stratification Methodologies</strong></p><p><br></p><p><strong>What is the landscape of risk stratification in Pulmonary Embolism (PE)?</strong></p><p><strong>Broadly, what interventions does each risk category group warrant?</strong></p><p><br></p><ul><li>Rule of Thumb: The greater the risk to the patient, the more likely aggressive interventions will be considered.</li><li>Most patients with PE are low risk:</li><li>Typically treated with systemic anticoagulation</li><li>Excellent prognosis&nbsp;</li><li>High risk PE patients typically have hemodynamic involvement and can present in shock requiring emergent management :</li><li>No contraindications + shock due to PE&nbsp;systemic thrombolysis</li><li>Absolute contraindications:</li><li>Prior history of ICH</li><li>Known cerebrovascular lesion</li><li>Known malignant intracranial neoplasm</li><li>Non-acute ischemic stroke, within the last 3 months</li><li>Suspect aortic dissection</li><li>Intermediate risk patients:</li><li>Management options exist and are tailored to each specific patient.</li><li>Most, but not all, patients with PE deemed to be at intermediate risk will do well with systemic anticoagulation.</li><li>Some patients are good candidates for catheter directed therapies such as thrombectomy or thrombolysis.</li><li>Who? We don’t really know with a high degree of certainty. Considerations should be made for those with numerous risk factors for poor PE-related outcomes OR those with significant cardiopulmonary reserve / excellent functional status who <strong>theoretically</strong> could benefit from more brisk reversal of their acute pulmonary hypertension.</li></ul><p><br></p><p>See more in depth show notes at <a href=\"https://www.criticalcaretime.com/episodes/35-pulmonary-embolism-part-iii\" rel=\"noopener noreferrer\" target=\"_blank\">criticalcaretime.com</a></p>","author_name":"Critical Care Time Podcast"}