Mais um guideline no TdC! Dessa vez discutimos a diretriz de tromboembolismo pulmonar da Sociedade Europeia de Cardiologia (ESC, European Society of Cardiology) que saiu em 2019. Pegamos 4 clinicagens do guideline e destrinchamos nesse episódio!

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MINUTAGEM

[02:19] Salves

[04:03] Dá pra mandar um TEP pra casa?

[09:20] E a TC serve para algo além do diagnóstico?

[13:51] Anticoagulantes

[16:25] Trombólise no TEP

[22:50] Posso fazer heparina + trombolítico?

[25:15] TEP subsegmentar

[32:00] Outras embolias

[32:47] Embolia amniótica

[35:30] Embolia gordurosa

[37:35] Embolia aérea

[42:27] Desafio diagnóstico

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REFERÊNCIAS:

KONSTANTINIDES, Stavros V. et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS) The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC). European heart journal, v. 41, n. 4, p. 543-603, 2020.

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ZONDAG, W. et al. Outpatient treatment in patients with acute pulmonary embolism: the Hestia Study. Journal of thrombosis and haemostasis, v. 9, n. 8, p. 1500-1507, 2011.

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CARRIER, M. et al. Subsegmental pulmonary embolism diagnosed by computed tomography: incidence and clinical implications. A systematic review and meta‐analysis of the management outcome studies. Journal of Thrombosis and Haemostasis, v. 8, n. 8, p. 1716-1722, 2010.

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AUJESKY, Drahomir et al. Outpatient versus inpatient treatment for patients with acute pulmonary embolism: an international, open-label, randomised, non-inferiority trial. The Lancet, v. 378, n. 9785, p. 41-48, 2011.

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MEYER, Guy et al. Fibrinolysis for patients with intermediate-risk pulmonary embolism. N engl j med, v. 370, p. 1402-1411, 2014

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Chatterjee S, Chakraborty A, Weinberg I, Kadakia M, Wilensky RL, Sardar P,

Kumbhani DJ, Mukherjee D, Jaff MR, Giri J. Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage:

a meta-analysis. JAMA 2014;311:24142421.