Pulmonary embolism in mechanically ventilated patients requiring computed tomography

Minet, Clémence; Lugosi, M.; Savoye, P. Y.; Menez, C.; Ruckly, Stéphane; Bonadona, Agnès; Schwebel, Carole; Hamidfar-Roy, Rébecca; Dumanoir, Perrine; Ara-Somohano, Claire; Ferretti, G.; Timsit, Jean‐François

doi:10.1097/ccm.0b013e318265e461

Cited by 45 publications

(53 citation statements)

References 37 publications

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“…However, the analysis of recent literature, showed a higher incidence of PE in comparison with the data published in the last decade . Moreover, it was well‐established that the development of PE was associated with a high mortality rate (7% to 27%), a high rate of nosocomial infections and a prolonged ICU and in‐hospital length of stay (LOS) . Eight years ago, we reported a low rate (1.9%) of PE in our ICU .…”

Section: Introductionmentioning

confidence: 59%

“…Eight years ago, we reported a low rate (1.9%) of PE in our ICU . Moreover, we are attentive of the small number of published studies investigating the incidence and prevalence of PE in ICUs …”

Section: Introductionmentioning

confidence: 79%

“…Venous thromboembolism (VTE), which includes pulmonary embolism (PE) and deep venous thrombosis (DVT), remains a major challenge and represents severe complications in the care of critically ill patients . Indeed, intensive care unit (ICU) patients are at a high risk of VTE because they are subject to several general risk factors for VTE (such as immobilization, age, obesity, past history of neoplasm, sepsis, recent surgery, trauma) and ICU‐related risk factors (such as sedation, central venous catheterization, respiratory or heart failure and the use of vasoactive drugs) . In fact, in the ICU, most patients are severely ill requiring sedation and mechanical ventilation (MV) .…”

Section: Introductionmentioning

confidence: 99%

“…In fact, in the ICU, most patients are severely ill requiring sedation and mechanical ventilation (MV) . However, despite recent advances in prophylactic, diagnostic and therapeutic modalities, PE remains one of the important causes of in‐hospital morbidity and mortality . In fact, PE is one of the three main illnesses frequently identified during autopsies, but clinically under‐diagnosed .…”

Section: Introductionmentioning

confidence: 99%

“…In fact, in ICU, PE is a difficult diagnosis, which may be missed because of a nonspecific clinical presentation, principally in patients requiring MV. As a consequence, the prevalence of PE, although well‐documented in the general population, remains unclear in ICU because systematic screening is not methodically performed . Up to this day, little is known about the incidence and prevalence of PE in ICU, with a reported rate ranging from 0.5% to 18.7% .…”

Section: Introductionmentioning

confidence: 99%

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Pulmonary embolism in intensive care units: More frequent or more Known? Prospective study of 75 cases

Bahloul

Regaieg

Dlela

et al. 2019

Clinical Respiratory J

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Purpose to evaluate the current rate of pulmonary embolism (PE) in our medico‐surgical intensive care unit (ICU), to identify risk factors, and to determine the outcome of PE in ICU. Methods We performed a prospective cohort study of consecutive patients requiring intensive care admission during a one‐year period. We included, in this prospective study, all the patients with confirmed PE admitted in ICU with more than 18 years of age, and expected to stay in ICU for more than 48 hours. Only the patients who had a clinical suspicion (unexplained hypoxemia and/or shock) for PE underwent diagnostic studies. Results During the study period, 842 patients were admitted in our ICU. One hundred and two patients were excluded. The diagnosis of PE was confirmed in 75 patients (10.1%). In our study, all patients (100%) had received some forms of pharmaceutical prophylaxis (PP) during ICU stay. The median time from ICU admission to diagnosis of PE was 6 days. The diagnosis of PE was made by spiral CT in 74 patients (98.7%), and by echocardiography in 1 case (1.3%). The mean ICU stay was 26.3 ± 26.5 days (median: 20 days). During their ICU stay, 73 patients (97.3%) developed one, or more, organ failure. Respiratory failure was the most observed (97.3%). Moreover, 38 patients (50.6%) developed nosocomial infections and 29 (38.6%) died. The multivariate analysis showed that the risk factors associated with mortality were the presence of shock the day of PE diagnosis and the presence of right ventricular dilatation on echocardiography. Conclusion Our findings confirm that subjects in the ICU are at high risk of PE, due to a high number of risk‐factors. PE was associated with higher ICU mortality and a significantly higher ICU LOS. Our results invite to revise the preventive strategies of deep venous thrombosis and PE in patients requiring ICU admission.

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Section: Introductionmentioning

confidence: 59%

Section: Introductionmentioning

confidence: 79%