Longembolie II: Diagnostische Onderzoeken en Interprofessionele Zorg

Diagnosing pulmonary embolism or PE involves imaging studies, such as CT angiography to visualize the pulmonary vasculature and a ventilation-perfusion scan to visualize pulmonary circulation and lung air distribution.

Additional tests that aid in diagnosing PE are the D-dimer test, which measures cross-linked fibrin fragments, indicating abnormal clotting activity, and ABG analysis, which may show low PaO2 levels. Chest X-rays may reveal nonspecific signs like atelectasis, while ECGs may show changes such as sinus tachycardia.

Next, for stable pulmonary embolism patients without cardiopulmonary instability, anticoagulant therapy should be started immediately with low-molecular-weight heparin or warfarin

For unstable PE patients, particularly those with hypotension or shock, prescribe thrombolytic therapy with a tissue plasminogen activator.

Additionally, Oxygen therapy for hypoxemia, opioids for pleural pain, IV fluids, and vasopressors for circulation support are recommended..

For unstable patients with massive PE and contraindications to thrombolytics, options include pulmonary embolectomy, ultrasound-guided catheter thrombolysis, or aspiration thrombectomy.