ABSTRACT
Historically, the diagnosis and treatment of pulmonary embolism (PE) have presented
challenges for clinicians (1). In the surgical intensive care unit (SICU), the diagnosis of
PE is often complicated by superimposed lung injury, and treatment decisions are often
affected by relative or absolute contraindications to anticoagulation or thrombolytic
therapy. At some time, most critically ill patients manifest clinical findings that are con-
sistent with PE, including dyspnea, chest pain, ventilation-perfusion (V/Q) mismatch, or elevated central venous pressure (CVP). A systematic approach to the diagnosis and treat-
ment of PE is necessary to minimize the possibility of a missed diagnosis and to prevent
the risk of unnecessary therapy.
