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Management of patients with high-risk pulmonary embolism: a narrative review

Overview of attention for article published in Journal of Intensive Care, March 2018
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#46 of 575)
  • High Attention Score compared to outputs of the same age (92nd percentile)
  • High Attention Score compared to outputs of the same age and source (94th percentile)

Mentioned by

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59 X users
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3 Facebook pages

Citations

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58 Dimensions

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199 Mendeley
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Title
Management of patients with high-risk pulmonary embolism: a narrative review
Published in
Journal of Intensive Care, March 2018
DOI 10.1186/s40560-018-0286-8
Pubmed ID
Authors

Takeshi Yamamoto

Abstract

High-risk pulmonary embolism (PE) is a life-threatening disorder associated with high mortality and morbidity. Most deaths in patients with shock occur within the first few hours after presentation, and rapid diagnosis and treatment is therefore essential to save patients' lives. The main manifestations of major PE are acute right ventricular (RV) failure and hypoxia. RV pressure overload is predominantly related to the interaction between the mechanical pulmonary vascular obstruction and the underlying cardiopulmonary status. Computed tomography angiography allows not only adequate visualization of the pulmonary thromboemboli down to at least the segmental level but also RV enlargement as an indicator of RV dysfunction. Bedside echocardiography is an acceptable alternative under such circumstances. Although it does not usually provide a definitive diagnosis or exclude pulmonary embolism, echocardiography can confirm or exclude severe RV pressure overload and dysfunction. Extracorporeal membrane oxygenation support can be an effective procedure in patients with PE-induced circulatory collapse. Thrombolysis is generally accepted in unstable patients with high-risk PE; however, thrombolytic agents cannot be fully administered to patients with a high risk of bleeding. Conversely, catheter-directed treatment is an optimal treatment strategy for patients with high-risk PE who have contraindications for thrombolysis and is a minimally invasive alternative to surgical embolectomy. It can be performed with a minimum dose of thrombolytic agents or without, and it can be combined with various procedures including catheter fragmentation or embolectomy in accordance with the extent of the thrombus on a pulmonary angiogram. Hybrid catheter-directed treatment can reduce a rapid heart rate and high pulmonary artery pressure and can improve the gas exchange indices and outcomes. Surgical embolectomy is also performed in patients with contraindications for or an inadequate response to thrombolysis. Large hospitals having an intensive care unit should preemptively establish diagnostic and therapeutic protocols and rehearse multidisciplinary management for patients with high-risk PE. Coordination with a skilled team comprising intensivists, cardiologists, cardiac surgeons, radiologists, and other specialists is crucial to maximize success.

X Demographics

X Demographics

The data shown below were collected from the profiles of 59 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 199 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 199 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 27 14%
Researcher 24 12%
Other 22 11%
Student > Postgraduate 20 10%
Student > Master 15 8%
Other 30 15%
Unknown 61 31%
Readers by discipline Count As %
Medicine and Dentistry 103 52%
Nursing and Health Professions 10 5%
Agricultural and Biological Sciences 3 2%
Pharmacology, Toxicology and Pharmaceutical Science 2 1%
Biochemistry, Genetics and Molecular Biology 2 1%
Other 5 3%
Unknown 74 37%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 35. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 December 2022.
All research outputs
#1,149,800
of 25,278,281 outputs
Outputs from Journal of Intensive Care
#46
of 575 outputs
Outputs of similar age
#25,416
of 337,827 outputs
Outputs of similar age from Journal of Intensive Care
#2
of 19 outputs
Altmetric has tracked 25,278,281 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 575 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 13.9. This one has done particularly well, scoring higher than 92% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 337,827 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 92% of its contemporaries.
We're also able to compare this research output to 19 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 94% of its contemporaries.