PULMONER EMBOLİ 2019

Year 2019, Volume: 1 Issue: 1, 51 - 63, 01.11.2019

Afşın İpekci

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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