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Review
. 2022 Apr 28:77:103684.
doi: 10.1016/j.amsu.2022.103684. eCollection 2022 May.

Evidence-based perioperative diagnosis and management of pulmonary embolism: A systematic review

Lamesgen Geta Abate  1   2 , Samuel Debas Bayable  1   2 , Melaku Bantie Fetene  3   2
Affiliations
Review

Evidence-based perioperative diagnosis and management of pulmonary embolism: A systematic review

Lamesgen Geta Abate et al. Ann Med Surg (Lond). .

Abstract

Background: The diagnosis and treatment of pulmonary embolism have multi-modal approach based on specificity, sensitivity, availability of the machine, and associated risks of imaging modalities.

Aim: This review aimed to provide shreds of evidence that improve perioperative diagnosis and management of suspected pulmonary embolism.

Methods: The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline 2020. After a clear criteria has been established an electronic searching database was conducted using PubMed, Google Scholar, Cochrane library, and Cumulative Index of Nursing and Allied Health Literature (CINAHL), with Key search terms included:('pulmonary embolism' AND' anesthesia management ', 'anticoagulation' AND 'pulmonary embolism', 'thrombolysis 'AND 'pulmonary embolism', 'surgery' AND' pulmonary embolism'), were used to draw the evidence.The quality of literatures were categorized based on WHO 2011 level of evidence and degree of recommendation, in addition, the study is registered with research registry unique identifying number (UIN) of reviewregistry1318." and has high quality based on AMSTAR2 assessment criteria.

Results: A totally of 27 articles were included [guidelines (n = 3), Cochrane (=5), systemic reviews (n = 7), meta-analyses (=2), RCT (n = 4), cohort studies (n = 3), and cross-sectional study (n = 3) and illegible articles identified from searches of the electronic databases were imported into the ENDNOTE software version X7.1 and duplicates were removed.

Discussion: Currently divergent and contradictory approaches are implemented in diagnosis and management for patients suspected of pulmonary embolism.

Conclusion: All perioperative patients, especially trauma victims, prostate or orthopedic surgery, malignancy, immobility, and obesity; smokers; and oral contraceptive users, antipsychotic medications are at increased risk of venous thromboembolism and need special caution during surgery and anesthesia.

Keywords: Anesthesia management; Anticoagulation; CASP, Critical Appraisal Skills Programmed; CTPA, Computed Tomography Pulmonary Angiography; DVT, Deep Venous Thrombosis; PE, Pulmonary Embolism; Pulmonary embolism; Thrombolysis; WHO, World Health Organization.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow chart for selection of studies using 2020 PRISMA flow diagram.
Fig. 2
Fig. 2
Algorithm for patients with suspected high-risk pulmonary embolism presenting with hemodynamic instability.
Fig. 3
Fig. 3
Algorithm for patients with suspected pulmonary embolism without hemodynamic instability.
See this image and copyright information in PMC

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