Embolia polmonare con instabilità emodinamica: dalle linee guida alla real life

A 86-years-old attended to the Emergency Department for shortness of breath, fever, vomit and diarrhoea. She was affected by: hypertension, diabetes, AF, CVI and bedridden sdr. In the shock room: BP 80/40mmHg, HR 110bpmAR, RR 30/min, SpO2 75% when breathing room air, T 38.2°C. GCS 3+5+6. She was in severe respiratory distress and she had a right lower limb oedema. Blood tests showed leukocytosis, low plt and high D-dimer values, as a CT scan identified PE. The patient was admitted to our SuCU. Despite the RVD, as we suspected sepsis, we gave her liquids, dopamine, piperacillin/tazobactam and UFH, improving her vitals in 120’. In conclusion, old patients with co-pathologies can have more then a cause of shock: sometimes it’s possible to treat and wait a couple of hours before deciding about fibrinolysis.