Pulmonary Embolism Treatment Systemic Thrombolysis - Exclude contraindications. - Indications: - Massive PE (definite indication) - High-risk submassive PE (risk/benefit) - Std dose alteplase = 100mg IV over 2 hrs - Low dose 0.5 mg/kg (up to 50mg IV) - 2% risk of ICH and 6% risk of other major bleeding with tPA (PIETHO) Catheter Directed Lysis - Useful in patients who are higher risk for thrombolysis. May be superior to anticoag alone-in intermediate risk PE. Embolectomy - May be useful in patients who fail above therapies, who have C/I to thrombolysis, or who require surgery for large RA thrombus Nick Mark MD @nickmmark #Pulmonary #Embolism #Treatment #AcutePE #Management #CriticalCare
