Perioperative pulmonary embolism. |
Sang Tae Kim |
Department of Anesthesiology and Pain Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea. kimst@chungbuk.ac.kr |
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Abstract |
Pulmonary thromboembolism (PTE) is a perioperative complication that requires prompt diagnosis and treatment to minimize mortality. Detection of deep vein thrombosis (DVT) suggests the presence of PTE. The clinical presentation of PTE is mainly hemodynamic and gas exchange abnormalities.
Diagnostic tools include ventilation/perfusion scan, pulmonary angiography, spiral CT, and echocardiography.
Therapeutic options include hemodynamic support with inotropics, anticoagulation, systemic thrombolysis, surgical embolectomy and an inferior vena cava filter. DVT prophylaxis should be considered in all operative patients with high risk. Anesthesiologists should consider the appropriate anticoagulant management before and after surgery to optimize anesthetic choices. |
Key Words:
Anticoagulation; Deep vein thrombosis; Pulmonary thromboembolism |
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