Why can't patients with pulmonary embolism get out of bed?

Written by Wang Chun Mei
Pulmonology
Updated on September 28, 2024
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Pulmonary embolism is a relatively common clinical disease, with many and complex inducing factors. The most common cause of pulmonary embolism in patients is due primarily to thrombi dislodging from the veins of the lower limbs or the pelvic deep veins, traveling through the bloodstream to the pulmonary arteries, thus causing the disease. Therefore, bed rest is essential during the acute phase of pulmonary embolism. The purpose of bed rest is to prevent further embolisms, to avoid the dislodging of pelvic or lower limb deep vein thrombi, which could lead to the formation of new thrombi. Therefore, for patients with pulmonary embolism, it is crucial to provide timely treatments such as thrombolysis to control the clinical symptoms caused by the pulmonary embolism effectively.

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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 a pulmonary embolism be detected by a CT scan?

CT can detect acute pulmonary embolism, using CT angiography, which is the preferred imaging method for diagnosing pulmonary embolisms. It mainly shows central filling defects, as well as eccentric and abdominal wall filling defects, and complete filling defects. A diagnosis of pulmonary embolism can be made through the visualization of these filling defects on a CT scan. Additionally, some indirect signs, such as pulmonary hypertension, right ventricular enlargement, and the common mosaic sign, can also be observed. These are characteristic CT manifestations of acute pulmonary embolism.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Pulmonary embolism belongs to which department?

Pulmonary embolism mainly refers to the detachment of thrombi in the blood, leading to the obstruction of the main trunk of the pulmonary artery and its branches, causing a series of syndromes. Pulmonary embolism is an emergency in clinical practice. If the patient's circulation becomes unstable after the embolism, thrombolytic therapy should be considered. If the patient's respiratory circulation remains stable after the embolism, anticoagulation therapy can be considered. In clinical practice, pulmonary embolism is primarily diagnosed through pulmonary artery CTA examination to further clarify the diagnosis, and patients generally consult the respiratory medicine department.

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Written by Wang Li Bing
Intensive Care Medicine Department
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What are the precursors of pulmonary embolism?

Pulmonary embolism is also relatively common in clinical practice. Its precursors may include varying degrees of respiratory difficulty, chest tightness, and shortness of breath, among others. If such symptoms occur, medical attention should be sought promptly, primarily to rule out the possibility of acute myocardial infarction. Pulmonary artery CTA can further confirm whether there is a pulmonary embolism. In cases of extensive pulmonary embolism, there is a high risk of sudden death, and aggressive thrombolytic and anticoagulation treatments should be administered. If the patient's chest tightness and shortness of breath are relieved after the aforementioned treatments, hospitalization for observation and treatment is still necessary.

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Written by Li Qiang
Intensive Care Unit
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Why does pulmonary embolism cause cardiac arrest?

The mechanisms causing cardiac arrest due to acute pulmonary embolism mainly encompass several aspects. One is a large-scale acute extensive pulmonary embolism, which prevents the blood from being ejected from the right heart, potentially leading to acute right heart failure. At this time, the entire body's blood circulation will encounter issues. Another scenario is that following the pulmonary embolism, it causes severe hypoxia. This hypoxia can lead to oxygen deficiency in all organs of the body, including the heart. The coronary arteries that supply nutrients to the heart can also become ischemic. Both of these factors can cause the heartbeat to lead to sudden cardiac arrest. These are the primary mechanisms that can cause a sudden stop in the heartbeat.