Ultrasound-Facilitated, Catheter-Directed Fibrinolysis for Acute Pulmonary Embolism (Registro nro. 22884)
[ vista simple ]
| 000 -Cabecera | |
|---|---|
| Campo de control interno | 03502nam a2200325 4500 |
| 001 - Número de control | |
| control field | ESSALUD |
| 005 - Fecha y hora de la última transacción | |
| Campo de control | 20260902142645.0 |
| 007 - Tipo material - Descripcion fisica - info general | |
| Tipo material - Descripcion fisica - info general | ta |
| 008 - Elementos de Longitud Fija - Información General | |
| Elementos de Longitud Fija - Información | t pe ||||| |||| 00| 0 spa d |
| 040 ## - Origen de la Catalogación | |
| Origen de la Catalogación | BMG |
| 041 ## - Idioma | |
| Idioma | eng |
| 100 ## - Autor | |
| Autor | Rosenfield, Kenneth |
| Rol del Autor | Autor |
| 9 (RLIN) | 54380 |
| 245 ## - Titulo | |
| Titulo | Ultrasound-Facilitated, Catheter-Directed Fibrinolysis for Acute Pulmonary Embolism |
| 300 ## - Páginas | |
| Paginación | páginas: 1979-1990 |
| 520 ## - Resumen | |
| Resumen | Background: Whether anticoagulation alone is an adequate treatment for acute, intermediate-risk pulmonary embolism is uncertain. Methods: We conducted a multinational, adaptive-design trial with blinded outcome adjudication. Patients with intermediate-risk pulmonary embolism (with a ratio of right ventricular end-diastolic diameter to left ventricular end-diastolic diameter of ≥1.0 and an elevated troponin level) were eligible if they had at least two indicators of cardiorespiratory distress (systolic blood pressure of ≤110 mm Hg, a heart rate of ≥100 beats per minute, or a respiratory rate of >20 breaths per minute). Patients were randomly assigned to undergo ultrasound-facilitated, catheter-directed fibrinolysis with alteplase plus anticoagulation (the intervention group) or anticoagulation alone (the control group) according to prespecified treatment protocols. The primary outcome was a composite of pulmonary embolism–related death, cardiorespiratory decompensation or collapse, or symptomatic recurrence of pulmonary embolism within 7 days. Results: The intention-to-treat population comprised 544 patients: 273 in the intervention group and 271 in the control group. The mean (±SD) age was 58.2±13.5 years, and 42.6% of the patients were women. A primary-outcome event occurred in 11 patients (4.0%; 95% confidence interval [CI], 2.3 to 7.1) in the intervention group and 28 (10.3%; 95% CI, 7.2 to 14.5) in the control group (relative risk, 0.39; 95% CI, 0.20 to 0.77; P=0.005). The effect was driven primarily by a lower risk of cardiorespiratory decompensation or collapse in the intervention group. Major bleeding occurred within 7 days after randomization in 11 patients (4.1%) in the intervention group and 6 (2.2%) in the control group (P=0.32); major bleeding occurred within 30 days in 11 patients (4.1%) and 8 patients (3.0%), respectively (P=0.64). No substantial between-group differences in the incidence of other serious adverse events were observed up to 30 days after randomization; no intracranial hemorrhage occurred. Conclusions: In patients with acute, intermediate-risk pulmonary embolism, ultrasound-facilitated, catheter-directed fibrinolysis plus anticoagulation led to a lower risk of the composite of pulmonary embolism–related death, cardiopulmonary decompensation or collapse, or symptomatic recurrence of pulmonary embolism within 7 days than anticoagulation alone. |
| 650 ## - Temas - Descriptores | |
| Temas - Descriptores | ANTICOAGULACIÓN |
| 9 (RLIN) | 53834 |
| 650 ## - Temas - Descriptores | |
| Temas - Descriptores | TROMBOEMBOLISMO |
| 9 (RLIN) | 32218 |
| 650 ## - Temas - Descriptores | |
| Temas - Descriptores | CARDIOLOGÍA |
| 9 (RLIN) | 11301 |
| 650 ## - Temas - Descriptores | |
| Temas - Descriptores | NEUMOLOGÍA |
| 9 (RLIN) | 25628 |
| 650 ## - Temas - Descriptores | |
| Temas - Descriptores | CUIDADOS INTENSIVOS GENERAL |
| 9 (RLIN) | 54115 |
| 650 ## - Temas - Descriptores | |
| Temas - Descriptores | RADIOLOGÍA GENERAL |
| 9 (RLIN) | 54381 |
| 700 ## - Autor Personal | |
| Autor Personal | Klok, Frederikus A. |
| 9 (RLIN) | 54382 |
| 700 ## - Autor Personal | |
| Autor Personal | Piazza, Gregory |
| 9 (RLIN) | 54383 |
| 700 ## - Autor Personal | |
| Autor Personal | Sharp, Andrew S.P. |
| 9 (RLIN) | 54384 |
| 700 ## - Autor Personal | |
| Autor Personal | Ní Áinle, Fionnuala |
| 9 (RLIN) | 54385 |
| 700 ## - Autor Personal | |
| Autor Personal | Jaff, Michael R. |
| 9 (RLIN) | 54386 |
| 700 ## - Autor Personal | |
| Autor Personal | Barco, Stefano |
| 9 (RLIN) | 54060 |
| 773 0# - Revista (Relacion con el numero) | |
| Host Biblionumber | 22717 |
| Host Itemnumber | 22665 |
| Ciudad, Editorial | Massachusetts NEJM Group |
| Codigo barras item/ejemplar | NEJM013 |
| Titulo de la Revista | The New England Journal of Medicine |
| Número de control de registro | ESSALUD |
| ISSN | 0028-4793 |
| 942 ## - Elementos de Koha | |
| Tipo de Documento | Artículos |
| Fecha procesamiento | 2026-08-28 |
| Catalogador | sqb |
No hay ítems disponibles.