Key result
Perioperative pulmonary thromboembolism requires prompt diagnosis and appropriate management, including hemodynamic support, anticoagulation, and careful anesthetic choices to minimize mortality.
This review summarizes the pathophysiology, diagnosis, prevention, and management of perioperative pulmonary thromboembolism, emphasizing the importance of appropriate anticoagulant management and diagnostic tools.
May inform perioperative protocols; leaves open need for prospective trials on optimal strategies.
Pulmonary thromboembolism (PTE) is a perioperative complication that requires prompt diagnosis and treatment to minimize mortality. Detection of deep vein thrombosis (DVT) suggests the presence of PTE. The clinical presentation of PTE is mainly hemodynamic and gas exchange abnormalities. Diagnostic tools include ventilation/perfusion scan, pulmonary angiography, spiral CT, and echocardiography. Therapeutic options include hemodynamic support with inotropics, anticoagulation, systemic thrombolysis, surgical embolectomy and an inferior vena cava filter. DVT prophylaxis should be considered in all operative patients with high risk. Anesthesiologists should consider the appropriate anticoagulant management before and after surgery to optimize anesthetic choices.
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Sang Tae Kim (2009) conducted a review in Perioperative pulmonary embolism and deep vein thrombosis. Perioperative management of pulmonary embolism was evaluated. Perioperative pulmonary thromboembolism requires prompt diagnosis and appropriate management, including hemodynamic support, anticoagulation, and careful anesthetic choices to minimize mortality.
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