PULMONER EMBOLİ 2019

Abstract

Pulmoner emboli (PE) yüksek mortaliteye sahip olan ve acil servislerde sık şüphelenilen olgulardan biridir. Acil servislerde şüphe/tanı oranı düşük ama mortalitesi yüksektir. Nonspesifik klinik bulgular ve geniş spektrumda semptoma sahip olduğundan dolayı tanısı zordur. Klinik tecrübeye bağlı yargı, klinik tahmin skorlama sistemleri, dışlama kriterleri ve D-dimer testi tanının dışlanmasında önemlidir. Transtorasik ekokardiyografi ve bilgisayarlı tomografi pulmoner anjiyografi (BTPA) özellikle hemodinamik instabil olgularda hızlı tanıda önemlidir. Ventilasyon/Perfüzyon sintigrafisi BTPA çekilemeyen ve radyasyondan kaçınmak istediğimiz hastalarda faydalıdır. PE’ erken risk sınıflaması ve instabil hastalarda hızlı reperfüzyon tedavisi hayat kurtarıcıdır. Bu derlemede acil servisin kırmızı bayraklarında olan PE’ nin tanı ve tedavisi hakkında European Respiratory Society (ERS) 2019 PE klavuzu eşliğinde bilgiler verilmiştir.

Keywords

• Pulmoner emboli,Hemodinamik instabilite

PULMONARY EMBOLISM 2019

Abstract

Pulmonary embolism (PE) is one of the most suspected cases in the emergency department with high mortality. The suspicion/diagnosis ratio is low in emergency departments but itsmortality is high. Diagnosis of PE is difficult because it has nonspecific clinical findings and a broad spectrum of symptoms. Judgment based on clinical experience, prediction rules, exclusion criteria, and D-dimer test are important in excluding the diagnosis. Transthoracic echocardiography and computed tomography pulmonary angiography (CTPA) are important in rapid diagnosis, especially in patients with hemodynamic instability. Ventilation / Perfusion scintigraphy is useful in patients who cannot receive BTPA and want to avoid radiation. Early risk classification of PE and rapid reperfusion therapy in unstable patients are life-saving. In this review, information about the diagnosis and management of PE, which is one of the red flags of the emergency department, is provided by the European Respiratory Society (ERS) 2019 guideline for PE.

Keywords

• Pulmonary embolism,Hemodynamic instability

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