Why do patients with pulmonary embolism feel sleepy?

Written by Yuan Qing
Pulmonology
Updated on September 26, 2024
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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 Yuan Qing
Pulmonology
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Can a secondary recurrence of pulmonary embolism be treated?

Pulmonary embolism, even if it recurs for the second time, is treatable, but the approach should differ from the first recurrence. It's vital to determine the cause of the pulmonary embolism, although many patients with this condition do not have an identifiable cause. For such patients, long-term oral anticoagulants might be recommended. With long-term use of oral anticoagulants, the likelihood of thrombosis, especially in the venous system, significantly reduces. This means that the chance of recurrence in patients also decreases considerably. However, if the cause can be identified, it is better to address and eliminate it. For instance, if the cause is long-term use of oral contraceptives or the presence of varicose veins, these primary or secondary factors should be resolved. The treatment should not just focus on anticoagulation or thrombolytic therapy, as there could still be a possibility of a future pulmonary embolism recurrence.

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Written by Wei Shi Liang
Intensive Care Unit
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Pulmonary Embolism Interventional Treatment Methods

Interventional treatment for pulmonary embolism is mainly used for large pulmonary embolisms in the main trunk or major branches of the pulmonary artery. It is applicable in the following scenarios: contraindications to thrombolysis and anticoagulation therapy, inefficacy after thrombolysis or aggressive medical treatment, or lack of surgical conditions. Interventional therapy for pulmonary embolism can involve removing the embolus or breaking it into fragments, allowing it to move to the distal pulmonary arteries, thereby opening the central pulmonary arteries, rapidly reducing pulmonary artery resistance, significantly increasing total pulmonary blood flow, improving cardiopulmonary hemodynamics, and right ventricular function. The treatment involves catheter fragmentation and suction of large clots in the pulmonary artery or performing balloon angioplasty, and it also enables local administration of small-dose thrombolysis. These are the primary methods of interventional treatment for pulmonary embolism.

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Written by Yuan Qing
Pulmonology
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What are the symptoms when pulmonary embolism becomes severe?

Pulmonary embolism can vary in severity, with serious cases primarily causing unstable vital signs. The disease primarily arises from venous thrombi in the venous system, which travel with the venous blood back to the right heart, and then with the blood flow from the right heart back to the aorta. If the thrombus is relatively large, it can easily become lodged in the pulmonary artery, forming a pulmonary embolism. The symptoms of pulmonary embolism can range from mild to severe. Based on the patient's symptoms and vital signs, pulmonary embolism is categorized into low risk, intermediate risk, and high risk. Low and intermediate risk typically indicate that the patient's vital signs are relatively stable, with normal blood pressure, heart rate, and pulse oximetry saturation. In severe cases, patients may exhibit noticeable symptoms such as coughing up blood, difficulty breathing, low blood pressure, shock, and oliguria. These represent the more severe cases of pulmonary embolism.

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Written by Wang Chun Mei
Pulmonology
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Why can't patients with pulmonary embolism get out of bed?

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 An Yong Peng
Pulmonology
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Can I eat lamb if I have pulmonary embolism?

Patients with pulmonary embolism can appropriately eat mutton, as it is acceptable in their case. For pulmonary embolism, it is advocated to follow a light diet, avoiding spicy, irritating food, and excessively greasy food to prevent aggravating the gastrointestinal burden of the patient. Additionally, it is acceptable for patients with pulmonary embolism to consume some meat, as long as it is not fatty meat. Once diagnosed with pulmonary embolism, patients should receive active treatment, which often requires anticoagulant therapy. If the condition is not too severe, simple anticoagulant treatment may allow the patient’s condition to recover. However, if the pulmonary embolism is more severe, thrombolytic therapy may be necessary. After thrombolytic treatment, vascular anticoagulant therapy is given to manage the patient's condition.