35. Pulmonary Embolism Masterclass with Dr. Rich Channick

In this episode of Critical Care Time, Dr. Nick Mark and Dr. Cyrus Askin interview Dr. Rich Channick, an expert in pulmonary embolism (PE) management, to discuss interventions for treating pulmonary emboli when anticoagulation alone is insufficient. They delve into challenging questions such as when to use half-dose or quarter-dose lytics, and when to opt for interventional radiology (IR) or surgical management. Dr. Channick shares his insights on risk stratification, the use of RV/LV ratios from CT scans versus echocardiograms, and the importance of considering a patient's overall clinical picture rather than relying solely on cutoffs. The discussion includes case studies to illustrate different approaches to PE management, the role of ECMO, and the use of IVC filters. The episode also touches on the importance of multidisciplinary care through Pulmonary Embolism Response Teams (PERT) and ongoing clinical trials aimed at improving PE treatment strategies.

Outlines

Part 1: Introduction, Risk Stratification

Part 2: Interventions, Anticoagulation, Evidence

Part 3: Advanced Management, High-Risk Cases

Part 4: Future Directions, Clinical Trials

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Critical Care Time

Part 1: Introduction, Risk Stratification

Introduction to Critical Care Time and Pulmonary Embolism Management

Risk Stratification and Initial Assessment of Pulmonary Embolism

Diagnostic Tools and Management Strategies for Intermediate-High Risk PE

Part 2: Interventions, Anticoagulation, Evidence

Anticoagulation Strategies and Catheter-Based Interventions

PERT Teams, Clinical Data, and the Role of Skepticism in PE Management

Part 3: Advanced Management, High-Risk Cases

Cardiopulmonary Reserve, TPA Dosing, and Management of High-Risk PE

ECMO in PE Management and IVC Filter Considerations

Part 4: Future Directions, Clinical Trials

PERT Teams, Clinical Trials, and Future Directions in PE Management

35. Pulmonary Embolism Masterclass with Dr. Rich Channick

Critical Care Time

Part 1: Introduction, Risk Stratification

00:02Introduction to Critical Care Time and Pulmonary Embolism Management

Introduction to Critical Care Time and Pulmonary Embolism Management

05:25Risk Stratification and Initial Assessment of Pulmonary Embolism

Risk Stratification and Initial Assessment of Pulmonary Embolism

13:34Diagnostic Tools and Management Strategies for Intermediate-High Risk PE

Diagnostic Tools and Management Strategies for Intermediate-High Risk PE

Part 2: Interventions, Anticoagulation, Evidence

23:02Anticoagulation Strategies and Catheter-Based Interventions

Anticoagulation Strategies and Catheter-Based Interventions

32:36PERT Teams, Clinical Data, and the Role of Skepticism in PE Management

PERT Teams, Clinical Data, and the Role of Skepticism in PE Management

Part 3: Advanced Management, High-Risk Cases

42:57Cardiopulmonary Reserve, TPA Dosing, and Management of High-Risk PE

Cardiopulmonary Reserve, TPA Dosing, and Management of High-Risk PE

51:31ECMO in PE Management and IVC Filter Considerations

ECMO in PE Management and IVC Filter Considerations

Part 4: Future Directions, Clinical Trials

1:02:28PERT Teams, Clinical Trials, and Future Directions in PE Management

PERT Teams, Clinical Trials, and Future Directions in PE Management