Is it good to place a filter for pulmonary embolism or not?

Written by Yuan Qing
Pulmonology
Updated on September 03, 2024
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Whether it is good or not to place a filter for pulmonary embolism mainly depends on the cause of the pulmonary embolism and whether there are indications for placing a filter.

Generally speaking, if pulmonary embolism is caused by the formation of blood clots in the lower limbs or the inferior vena cava, placing a filter can generally be beneficial. However, not all cases of lower limb venous thrombosis require a filter. Filters are usually only used for deep or large vein thromboses that are not suitable for thrombectomy or thrombolysis treatments. If a filter is placed under other conditions, it is very likely that thrombosis will re-form on the surface of the filter, potentially leading to some recurrent pulmonary embolisms or iatrogenic pulmonary embolisms. Therefore, the decision to place a filter is complex and requires a doctor to weigh the pros and cons before deciding whether or not to proceed.

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Written by Wang Li Bing
Intensive Care Medicine Department
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The most common symptoms of pulmonary embolism.

Pulmonary embolism is also relatively common in clinical practice, primarily caused by an embolus blocking the pulmonary artery system, leading to a group of clinical syndromes. The clinical manifestations of pulmonary embolism mainly include the following points: The first is that patients may experience unexplained difficulty breathing and shortness of breath, especially after activity. The second is that patients experience significant chest pain. The third may be accompanied by hemoptysis, but usually, the amount of blood expectorated is not large. The fourth is that patients may experience restlessness, panic, and even a sense of impending doom. Clinically, there sometimes appears the so-called triad, which includes simultaneous occurrence of difficulty breathing, chest pain, and hemoptysis, etc. Pulmonary embolism is primarily diagnosed clinically through pulmonary artery CT.

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Written by Yuan Qing
Pulmonology
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Can acute pulmonary embolism be cured by anticoagulation?

Anticoagulation has a partial curative effect on acute pulmonary embolism. Based on the area of the embolism and the patient's vital signs, it is classified into mild, moderate, and severe pulmonary embolism. If it is a mild to moderate pulmonary embolism, anticoagulation can completely cure it, because anticoagulation can help the body's fibrinolytic system remove the blood clots that have already formed, and it can also prevent new clots from forming. However, in cases of severe pulmonary embolism, especially when the patient presents unstable vital signs and is in life-threatening condition, it is not advisable to rely solely on anticoagulant therapy. This is because the effect of anticoagulant treatment is relatively slow, and it requires a certain amount of time for the body's immune and fibrinolytic systems to clear the embolism. Therefore, at such times, thrombolytic treatment is recommended. Of course, this requires an experienced physician to assess the patient's vital signs and overall condition.

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Written by Wang Chun Mei
Pulmonology
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What should I do if I have pulmonary embolism and asthma?

Pulmonary embolism is a very common type of disease clinically, and its triggering factors are numerous and complex. For such patients, the main triggering factors are usually the detachment of thrombi from the pelvic deep veins and the lower limb deep veins, leading to pulmonary artery embolism. Therefore, the clinical symptoms that appear in these patients are mainly difficulty breathing, chest tightness, chest pain, and some patients may experience coughing, coughing up blood, shortness of breath, and even wheezing. Thus, for such patients, it is first necessary to clarify the cause of the disease, and then provide the patient with oxygen, thrombolysis, anticoagulation, and other symptomatic treatments. Usually, after effective symptomatic treatment, when the embolism location is effectively controlled, the symptoms of wheezing and air blockage that the patient experiences will also be significantly improved.

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Written by Yuan Qing
Pulmonology
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Why do patients with pulmonary embolism feel sleepy?

Patients with pulmonary embolism primarily suffer from emboli within the venous system, which travel back to the right heart and then become lodged in the pulmonary artery, forming a pulmonary artery thrombus. This reduces pulmonary blood flow and impacts the exchange of air in the lungs, leading to hypoxia in the patient. Following hypoxia, the brain tends to enter a sleepy state, thus many patients with pulmonary embolism exhibit sleepiness. This sleepiness is related to the pathophysiological mechanisms of pulmonary embolism. At this point, it is crucial to provide sufficient oxygen to the patient to address their hypoxemia. Ultimately, the most fundamental treatments are prompt thrombolysis or anticoagulation therapy to resolve the embolus, addressing the condition fundamentally.

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Written by Wei Shi Liang
Intensive Care Unit
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Can pulmonary embolism lead to pneumonia?

Pulmonary embolism itself does not cause pneumonia; however, during the treatment of pulmonary embolism, procedures such as oral tracheal intubation and the creation of an artificial airway might be employed. These can lead to nosocomial infections of iatrogenic origin, resulting in pneumonia. Pulmonary embolism often manifests as unexplained respiratory difficulty, pleuritic pain, tachycardia, and decreased oxygen saturation. Other high-risk factors include being over the age of 40, having a history of DVT (Deep Vein Thrombosis), obesity, prolonged immobilization, stroke, congestive heart failure, malignancy, lower limb fracture, anesthesia time exceeding 30 minutes during surgery, pregnancy and childbirth, use of estrogen, and a hypercoagulable state. These are all potential high-risk factors for pulmonary embolism.