The Role of the Pulmonary Embolism Response Team: How to Build One, Who to Include, Scenarios, Organization, and Algorithms

Galmer, Andrew; Weinberg, Ido; Giri, Jay; Jaff, Michael R.; Weinberg, Mitchell D.

doi:10.1053/j.tvir.2017.07.012

Cited by 11 publications

(7 citation statements)

References 7 publications

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“…9,10 PERTs are diverse in their structure and resources. 11,12 However, it is not known whether this diversity extends to treatments and outcomes. 13…”

Section: Introductionmentioning

confidence: 99%

“…9,10 PERTs are diverse in their structure and resources. 11,12 However, it is not known whether this diversity extends to treatments and outcomes. 13 We provide the first national, multicenter analysis of patients cared for by eight US PERTs; describing the frequency of team activation, patient characteristics, PE severity, treatments delivered, and outcomes.…”

Section: Introductionmentioning

confidence: 99%

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A multidisciplinary pulmonary embolism response team (PERT)—experience from a national multicenter consortium

Schultz¹,

Giordano²,

Zheng³

et al. 2019

Pulm. circ.

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Background We provide the first multicenter analysis of patients cared for by eight Pulmonary Embolism Response Teams (PERTs) in the United States (US); describing the frequency of team activation, patient characteristics, pulmonary embolism (PE) severity, treatments delivered, and outcomes. Methods We enrolled patients from the National PERT Consortium™ multicenter registry with a PERT activation between 18 October 2016 and 17 October 2017. Data are presented combined and by PERT institution. Differences between institutions were analyzed using chi-squared test or Fisher's exact test for categorical variables, and ANOVA or Kruskal-Wallis test for continuous variables, with a two-sided P value < 0.05 considered statistically significant. Results There were 475 unique PERT activations across the Consortium, with acute PE confirmed in 416 (88%). The number of activations at each institution ranged from 3 to 13 activations/month/1000 beds with the majority originating from the emergency department (281/475; 59.3%). The largest percentage of patients were at intermediate–low (141/416, 34%) and intermediate–high (146/416, 35%) risk of early mortality, while fewer were at high-risk (51/416, 12%) and low-risk (78/416, 19%). The distribution of risk groups varied significantly between institutions ( P = 0.002). Anticoagulation alone was the most common therapy, delivered to 289/416 (70%) patients with confirmed PE. The proportion of patients receiving any advanced therapy varied between institutions ( P = 0.0003), ranging from 16% to 46%. The 30-day mortality was 16% (53/338), ranging from 9% to 44%. Conclusions The frequency of team activation, PE severity, treatments delivered, and 30-day mortality varies between US PERTs. Further research should investigate the sources of this variability.

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“…9,10 PERTs are diverse in their structure and resources. 11,12 However, it is not known whether this diversity extends to treatments and outcomes. 13…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A multidisciplinary pulmonary embolism response team (PERT)—experience from a national multicenter consortium

Schultz¹,

Giordano²,

Zheng³

et al. 2019

Pulm. circ.

View full text Add to dashboard Cite

show abstract

“…Small groups may have better team efficiency but at the expense of limiting the involvement of other interested stakeholders. On the contrary, a large group may have restricted efficiency but benefit from multidisciplinary breadth [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

“…Institutions with infrastructure already in place may have an advantage in initiating the development of such a team. However, for institutions with limited resources, the initial rollout of PE response teams, such as advertisement and expansion to other divisions and specialties, may carry an additional financial burden [ 22 ]. On another note, it is also challenging to receive buy-in from physicians to participate in PE response teams, as there is currently no available method to reimburse participation in interdisciplinary teams and participation is still based on volunteerism [ 17 ].…”

Section: Impact To Datementioning

confidence: 99%

Pulmonary Embolism Response Teams: Theory, Implementation, and Unanswered Questions

Bejjani

Khairani

Campia

et al. 2022

JCM

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Pulmonary embolism (PE) continues to represent a significant health care burden and its incidence is steadily increasing worldwide. Constantly evolving therapeutic options and the rarity of randomized controlled trial data to drive clinical guidelines impose challenges on physicians caring for patients with PE. Recently, PE response teams have been developed and recommended to help address these issues by facilitating a consensus among local experts while advocating the management of acute PE according to each individual patient profile. In this review, we focus on the clinical challenges supporting the need for a PE response team, report the current evidence for their implementation, assess their impact on PE management and outcomes, and address unanswered questions and future directions.

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“…Occasionally, and if feasible, the patient or a family member is included in those conversations. To date, there are 32 published descriptions or reviews of how various PERTs establish, organize, operate, and/or manage their programs (Table ) . To identify published studies on PERT, we conducted a systematic search of the literature for publications in MEDLINE and EMBASE from inception to November 2018 using the following search strategy: (pulmonary) and (embolism) and (response) and (team or teams) or (PERT) or (PERTs).…”

Section: Structure and Operation Of Pertmentioning

confidence: 99%

Pulmonary embolism response teams: Purpose, evidence for efficacy, and future research directions

Rosovsky

Zhao

Sista

et al. 2019

Research and Practice in Thrombosis and Haemostasis

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Pulmonary embolism (PE) is a major cause of morbidity and mortality in the United States. Although new therapeutic tools and strategies have recently been developed for the diagnosis and treatment of patients with PE, the outcomes for patients who present with massive or high‐risk PE remain dismal. To address this crisis, pulmonary embolism response teams (PERTs) are being created around the world in an effort to immediately and simultaneously engage multiple specialists to determine the best course of action and coordinate the clinical care for patients with acute PE. The scope of this review is to describe the PERT model and purpose, present the structure and organization, examine the available evidence for efficacy and usefulness, and propose future directions for research that is needed to demonstrate the value of PERT and determine if this multidisciplinary approach represents a new standard of care.

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The Role of the Pulmonary Embolism Response Team: How to Build One, Who to Include, Scenarios, Organization, and Algorithms

Cited by 11 publications

References 7 publications

A multidisciplinary pulmonary embolism response team (PERT)—experience from a national multicenter consortium

A multidisciplinary pulmonary embolism response team (PERT)—experience from a national multicenter consortium

Pulmonary Embolism Response Teams: Theory, Implementation, and Unanswered Questions

Pulmonary embolism response teams: Purpose, evidence for efficacy, and future research directions

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