16. Pulmonary Embolism Part II

In this episode of Critical Care Time, co-hosts Dr. Nick Mark and Dr. Cyrus Askin delve into the treatment of pulmonary embolism (PE), building on the foundational knowledge established in part one. They discuss a case of a 45-year-old male who develops a large occlusive PE post-surgery, emphasizing the importance of risk stratification using tools like the ESC guidelines, BOVA, and PESI scores to determine the appropriate level of intervention. The hosts outline the four pillars of PE treatment: correcting hypoxemia, anticoagulation, optimizing hemodynamics, and thrombolysis or intervention, while also advocating for the use of PERT teams to facilitate multidisciplinary decision-making. They explore the nuances of anticoagulation choices, thrombolysis options (including catheter-directed thrombolysis), hemodynamic support, and the potential role of ECMO in severe cases, concluding with a discussion on the importance of individualized treatment plans and proactive planning for potential complications.