Diagnostic pathways in acute pulmonary embolism: recommendations of the PIOPED II investigators.

Diagnostic pathways in acute pulmonary embolism: recommendations of the PIOPED II investigators. Research Abstract Details 

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Diagnostic pathways in acute pulmonary embolism: recommendations of the PIOPED II investigators. Abstract Text:

PURPOSE: To formulate comprehensive recommendations for the diagnostic approach to patients with suspected pulmonary embolism, based on randomized trials. METHODS: Diagnostic management recommendations were formulated based on results of the Prospective Investigation of Pulmonary Embolism Diagnosis II (PIOPED II) and outcome studies. RESULTS: The PIOPED II investigators recommend stratification of all patients with suspected pulmonary embolism according to an objective clinical probability assessment. D-dimer should be measured by the quantitative rapid enzyme-linked immunosorbent assay (ELISA), and the combination of a negative D-dimer with a low or moderate clinical probability can safely exclude pulmonary embolism in many patients. If pulmonary embolism is not excluded, contrast-enhanced computed tomographic pulmonary angiography (CT angiography) in combination with venous phase imaging (CT venography), is recommended by most PIOPED II investigators, although CT angiography plus clinical assessment is an option. In pregnant women, ventilation/perfusion scans are recommended by many as the first imaging test following D-dimer and perhaps venous ultrasound. In patients with discordant findings of clinical assessment and CT angiograms or CT angiogram/CT venogram, further evaluation may be necessary. CONCLUSION: The sequence for diagnostic test in patients with suspected pulmonary embolism depends on the clinical circumstances.

Diagnostic pathways in acute pulmonary embolism: recommendations of the PIOPED II investigators. Publishing Authors By Initials

For similar respiratory tract diseases: lung diseases: pulmonary embolism research abstracts see: respiratory tract diseases: lung diseases: pulmonary embolism research

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Diagnostic pathways in acute pulmonary embolism: recommendations of the PIOPED II investigators. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: The American journal of medicine

VOLUME: 119

Page Numbers: 1048-55

Journal Abbreviation: Am. J. Med.

ISSN: 1555-7162

DAY: 3

MONTH: Dec

YEAR: 2006

Diagnostic pathways in acute pulmonary embolism: recommendations of the PIOPED II investigators. Information

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LANGUAGE: eng

NlmUniqueID: 267200

Diagnostic pathways in acute pulmonary embolism: recommendations of the PIOPED II investigators. Keywords Mesh Terms:

KEYWORDS: Pulmonary Embolism

MESH TERMS: diagnosis

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Grant and Affiliation Information for Diagnostic pathways in acute pulmonary embolism: recommendations of the PIOPED II investigators.

AFFILIATION: Department of Research, St. Joseph Mercy Oakland Hospital, Pontiac, Mich 48341-5023, USA. steinp@trinity-health.org

Country: United States

AGENCY: United States NHLBI

GRANT: HL67453

ACRONYM: HL

MEDLINETA: Am J Med

REFSOURCE: Am J Med. 2006 Dec;119(12):1001-2

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