A filter used to block clots from passing from the veins in the legs to the arteries of the lung does not improve mortality rates for most patients suffering a pulmonary embolism. However, if a patient is unstable – in shock or requires a ventilator – filters can save lives.
Furthermore, for unstable patients with a pulmonary embolism, it is crucial they receive clot-dissolving medications known as thrombolytic therapy.
The findings come from a set of three research articles on pulmonary embolism treatment published by Michigan State University's Paul Stein in the May edition of the American Journal of Medicine. The findings are based on a study of more than two million patients suffering from the sometimes deadly clots that travel to the lungs and block arteries.
Stein said the studies provide clearer guidance on what treatments are most effective for patients, specifically in regard to vena cava filters and thrombolytic therapy.
"There has been an increase in the use of vena cava filters in the past several years for patients who arrive at a hospital suffering from a pulmonary embolism," said Stein, a professor in osteopathic medical specialties and also director of research at St. Mary Mercy Hospital in Livonia, Mich."But it appears the vast majority of filters that are placed in patients with pulmonary embolism may not reduce mortality."
"These studies provide strong evidence on when filters reduce mortality and when they will not," he said. "Only a small percentage of patients suffering from a pulmonary embolism are in shock or in need of ventilation support, and therefore only a small proportion need a filter."
Stein said for unstable patients it is vital that in addition to using a filter, they receive thrombolytic therapy, which is much less of a risk than the surgical removal of a clot known as an embolectomy.
"Only about a third of unstable patients receive thrombolytic therapy," he said. "The reason may be doctors are afraid that patients will suffer from excessive bleeding. But the data show thrombolytic therapy would save lives if used more frequently."
As for an embolectormy, Stein's team found that in most surgical centers, unless the clinicians are highly specialized and experienced, the mortality rate is high. In most hands, he said, thrombolytic therapy would save more lives.
The findings were from a nationwide government database, the Nationwide Inpatient Sample, and included data on more than two million patients who suffered a pulmonary embolism between 1999 and 2008.
Michigan State University has been working to advance the common good in uncommon ways for more than 150 years. One of the top research universities in the world, MSU focuses its vast resources on creating solutions to some of the world's most pressing challenges, while providing life-changing opportunities to a diverse and inclusive academic community through more than 200 programs of study in 17 degree-granting colleges.
Jason Cody | EurekAlert!
Researchers release the brakes on the immune system
18.10.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn
Norovirus evades immune system by hiding out in rare gut cells
12.10.2017 | University of Pennsylvania School of Medicine
University of Maryland researchers contribute to historic detection of gravitational waves and light created by event
On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...
Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.
Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....
Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).
When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...
Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.
How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...
Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.
It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...
17.10.2017 | Event News
10.10.2017 | Event News
10.10.2017 | Event News
20.10.2017 | Information Technology
20.10.2017 | Materials Sciences
20.10.2017 | Interdisciplinary Research