The subject of pulmonary embolism
Briefly
pulmonary embolism (PTE)
Pulmonary thromboembolism
The process of forming a fibrin clot in the bloodstream is called thrombus, now if a part of this clot is separated and migrates to another organ through the bloodstream, an embolism occurs. If this organ is the lung, it is called a pulmonary embolism.
Symptoms of pulmonary embolism:
Pulmonary embolism does not have specific symptoms, but it can be suspected by observing some of the following symptoms
1_ shortness of breath and tachypnea
2_ Chest pain
3_ Cough
4_ Anxiety
5_ bloody sputum (hemoptysis)
6_ Tachycardia
The occurrence of pulmonary embolism after DVT has been observed in 80% of untreated DVT patients.
Clinically, if the patient has a history of surgery, malignancy, DVT and PTE, the occurrence of pulmonary embolism is more likely.
Pulmonary embolism treatment:
The cornerstone of pulmonary embolism treatment is usually based on anticoagulant drugs, unless the patient has suffered from shock or massive PTE.
In this case, thrombolytic drugs are considered for the patient (provided that the patient is not exposed to bleeding and the systolic blood pressure is less than 90 ml of mercury).
According to the recommendation of the American College of Chest Physicians (ACCP), starting treatment with low molecular weight heparin such as enoxaparin (LMWH) and fondaparinux is preferable to treatment with heparin (UFH), and if the patient receives LMWH slow, prescribing it once a day is preferable to prescribing it twice a day.
Administration of oral anticoagulant (warfarin) should also be started as soon as pulmonary embolism is diagnosed, along with LMWH, UFH or fondaparinux, this process should continue for at least 5 days until the patient’s INR value reaches more than 2 and for at least 24 Stay above 2 o’clock. (preferably 2.5)
A patient with pulmonary embolism should receive anticoagulant medicine for at least three months.
The dose of enoxaparin in a patient with pulmonary embolism is equivalent to 1.5 mg per body weight every 24 hours or 1 mg/kg bid (subcutaneous administration).
The dose of heparin (UFH) in pulmonary embolism starts with a loading dose of 5000 units (75 units per kilogram of body weight) intravenously, followed by a dose of 18 units per kilogram of body weight per hour as a intravenous infusion. will continue.
Fondaparinux dose in pulmonary embolism:
If the patient’s weight is less than 50 kg, he receives 5 mg of fondaparinux subcutaneously every 24 hours, and if the patient weighs between 50 and 100 kg, he receives 7.5 mg of fondaparinux subcutaneously every 24 hours.
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This post is written by deture