Pulmonary embolism prophylaxis and treatment: What's right, what's wrong, and the future

Chinese Medical Journal - Pulmonary and Critical Care Medicine, Journal Year: 2025, Volume and Issue: 3(1), P. 1 - 5

Published: March 1, 2025

Recognition of the importance effective pulmonary embolism treatment and prophylaxis has improved inpatient care in many settings. Recommended drug acute have changed little over past 10 years. However, new information emerged, which when combined with early pharmacology studies unfractionated heparin low molecular weight heparin, clearly shows important deficits current practice that, if remedied, could reduce risk likely save lives. These involve ensuring bioavailability dosing by abandoning once-daily dosing, adopting weight- or weight-category based twice daily continuous infusion critically ill patients. For treatment, failure to recognize that presenting patients often subnormal perfusion resulting unpredictable subcutaneous anticoagulant meant undertreatment, delay reaching a therapeutic level, assuredly timely improvement as well recurrent thromboembolism. Intravenous should be rapidly adopted first for until normal hemodynamic values are restored cutaneous returns. Treatments under development include clinical investigation intensive unit (ICU) receiving intravenous prophylaxis, weight-based, targeting an level anti-Xa units is both safe. The same would useful although return initial anticoagulation more easily monitored activated partial thromboplastin time (aPTT) easy standard adopt. Pulmonary clot removal being accomplished suction thrombectomy catheter-directed lysis, each its own different procedural characteristics. Whether either confers benefit compared conscientiously administered cannot shown ongoing using control perfusion. Factor XI/XIa inhibition another approach studied. Another lytic therapy study, administering inhibitor alpha-2-antiplasmin, may cause less bleeding than tissue plasminogen activators.

Language: Английский

Kalkulierte Antibiotikatherapie bei lebensbedrohlichen Infektionen – aktuelle Konzepte und Kontroversen

Die Anaesthesiologie, Journal Year: 2025, Volume and Issue: unknown

Published: May 15, 2025

Language: Английский