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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The incidence of pulmonary embolism and deep vein thrombosis was measured in 50 matched pairs of patients undergoing common surgical procedures with preoperative and postoperative ventilation-perfusion lung scans and the fibrinogen uptake test. One patient in each pair was treated with intravenous dextran 70 and pneumatic leggings. The incidence of pulmonary embolism among the treated patients was significantly reduced from 24% to 8%, but the incidence of deep vein thrombosis was not significantly reduced (34% to 24%).
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PMID:Effect of intravenous dextran 70 and pneumatic leg compression on incidence of postoperative pulmonary embolism. 100 Jan 95

A randomized double-blind trial of prophylaxis of thromboembolism in surgical patients judged by clinical morbidity has been completed. Altogether 831 patients over 40 years of age who underwent elective surgery of the stomach, biliary system, or colon received either dextran 70 or normal saline before the operation. Thirteen of the 435 patients on saline and three of the 396 on dextran developed pulmonary embolism. Eight of these 16 patients died of pulmonary embolism--seven in the saline group and one in the dextran group. As detected either clinically or by 125I-fibrinogen scanning the incidence of deep vein thrombosis was similar in the two groups. There was no increased incidence of excessive bleeding in patients on dextran though clinical impression suggested that some patients on dextran bled excessively. This trial showed that dextran 70 administered by intravenous drip during operation is effective in preventing pulmonary embolism and, in particular, reducing mortality from this cause. It seems to be as effective as subcutaneous heparin but is easier to administer and places less of a burden on nursing services.
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PMID:Dextran 70 in prophylaxis of thromboembolic disease after surgery: a clinically oriented randomized double-blind trial. 109 19

A prospective double-blind study was instituted in a group of 150 general surgical patients to test the effectiveness of mini-dose heparinization in the pre- and postoperative periods. There was a 21 per cent reduction in the incidence of deep venous thrombosis in the heparin treated group. A radiopharmaceutical imaging technique with 99m-technetium macroaggregated albumin was used to evaluate the deep venous system. The procedure proved to be simple, safe, and painless; however, it was difficult to differentiate venous stasis from deep venous thrombosis. A negative study was good evidence that deep venous thrombosis did not exist. An additional benefit of this procedure was that a perfusion lung study could be obtained which provided additional information regarding pulmonary embolism without injecting additional radiopharmaceutical. Again, the negative perfusion lung study provided more information.
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PMID:Evaluation of mini-dose heparin administration as a prophylaxis against postoperative pulmonary embolism: a prospective double-blind study. 109 61

It is imperative that the orthopedic surgeon recognize the magnitude of the problem of thromboembolic disease. It is the most common complication of trauma or surgical procedures. Because the clinical signs and symptoms of deep venous thrombosis are so variable, and since pulmonary embolism is often the first sign of deep venous thrombosis, we must continue to refine our techniques for screening and diagnosis. The 125-I fibrinogen localization of propagating venous thrombi in the legs is a very promising and sensitive screening procedure. With refinements, the Doppler effect flowmeter and impedance phlebography may prove to be valuable screening techniques. Venography is still one of the most effective procedures in detecting venous thrombi and remains the standard of detection. The search must continue for better methods of prevention, diagnosis, and treatment.
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PMID:The detection of venous thrombosis. 109 64

In a prospective study, thrombosis of the femoral or popoliteal veins was discovered at operation in nine of eighty-one patients requiring amputation of a lower extremity for arterial insufficiency. One week postoperatively, all nine patients had evidence of pulmonary embolism on the lung scan. Embolization was documented by arteriography in two patients and at autopsy in a third patient. In none of these patients was there clinical evidence of venous thrombosis prior to operation. Two of the subjects with proved thrombosis died during study, a mortality of 22 percent, whereas the mortality for the entire group was 10 percent. It is concluded that the deep venous system of patients requiring amputation for ischemia should be examined carefully at operation. These patients have a high incidence of deep venous thrombosis and the discovery of thrombus at the time of operation places them in a particularly high risk group.
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PMID:Pulmonary embolism associated with surgically proved deep venous thrombosis. 113 May 88

A retrospective study of Scottish hospital inpatients aged 15 years or less has revealed, over a 4-year period, 36 cases of venous thrombosis or phlebitis. Of these 10 were considered to have deep venous thrombosis; 2 cases were associated with obvious pulmonary embolism and 2 cases developed chronic venous insufficiency. change in the coding allocations are proposed. There are "high risk" situations in childhood disease in which a diagnosis of venous thromboembolic disease should be considered and investigated.
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PMID:Venous thromboembolism in infancy and childhood. 113 Aug 20

Eleven patients with deep venous thrombosis were treated with streptokinase. Lysis of thrombi and prevention of pulmonay embolism were achieved in eight patients. Bleeding from the operative wound necessitated transfusions in seven patients. Fibrinolytic treatment of deep venous thrombosis lyses the floating portion of the thrombi. Protection against pulmonary embolism may be expected. The fibrinolytic effect of streptokinase is rapid; its value can be answered only by follow-up examinations.
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PMID:Fibrinolytic treatment of postoperative deep venous thrombosis. 116 85

A safe, sensitive and convenient technique using 131-I fibrinogen for detecting deep venous thrombosis in postoperative patients has been developed. A total of 47 volunteers over age 40 years about to undergo major operation were studied prospectively. Neither in 20 patients given heparin as part of the surgical procedure or for prevention of superficial phlebitis in the arm during intravenous therapy nor in the 27 others not given anticoagulants before, during or after operations was there evidence of venous thrombosis in the leg or pulmonary embolism either by the 131-I fibrinogen scan nor by clinical course. A retrospective review of hospital records confirmed the relative rarity of pulmonary embolism as a cause of identified morbidity and mortality in surgical patients. Of 54, 183 adult patients discharged from the University Hospitals of Cleveland during 1972 and 1973, 197, or 0.4 per cent, were diagnosed as having pulmonary embolism, and of these only 32, or 16 per cent, occurred in postoperative surgical patients. A review of the autopsy records of the same institution for the same time also revealed a low incidence of deaths due to pulmonary embolism among the surgical population, only 180, or 0.8 per cent, of the 22, 449 adult surgical admissions. Although feasible to perform, the value of the radiofibrinogen method of detecting deep venous thrombosis in postoperative patients as a routine measure is questioned.
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PMID:The frequency and detection of serious postoperative thromboembolic disease. 116 51

The incidence of postoperative deep venous thrombosis in the lower limbs and of pulmonary embolism has been studied in 49 patients operated upon for gallbladder and gastric diseases. 125I fibrinogen test was performed preoperatively and usually five times postoperatively. Pulmonary scintigraphy was also performed preoperatively and usually twice after the operation. An attempt was made to evaluate the prophylactic effect of Dextran 40. Only one patient developed a deep vein thrombosis without clinical signs. Postoperative pulmonary embolism was found in 13 patients, all but one clinically silent. The second postoperative pulmonary scintigraphy showed that the emboli had disappeared or diminished in 6 patients. Because of the low number of patients with deep venous thrombosis the prophylactic effect of Dextran 40 could not be assessed. The present investigation showed that the incidence of deep venous thrombosis in the legs was low after operations in the upper part of the abdomen while the incidence of pulmonary embolism was high. No connection between leg vein thrombosis and pulmonary embolism could be demonstrated.
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PMID:Postoperative leg vein thrombosis and pulmonary embolisn after upper abdominal operations. A prospective study with 125I fibrinogentest and pulmonary scintigraphy. 118 58

Doppler ultrasound was used to study 120 legs of 106 patients with suspected deep vein thrombosis (DVT) or pulmonary embolism. Venography was subsequently performed in all. DVT was confirmed by venography in 44 legs and was confined to the calf in 10 of these. Ultrasound detected three calf thromboses and 29 out of 34 more extensive thromboses. Of five undetected thrombi that were proximal to the calf one was associated with partial occlusion and four with extensive collateral circulation. Of the 76 limbs without venographic evidence of thrombosis 21 were thought to have DVT by ultrasound; 18 of these false-positive results could be attributed to external compression of veins, two to excessive tenderness precluding adequate examination; and in one no explanation was found. This test gives more accurate results than judging by clinical signs alone, but users must be aware of its limitations and, particularly, the causes of false-positive and false-negative results.
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PMID:Value of Doppler ultrasound in diagnosis of clinically suspected deep vein thrombosis. 120 67


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