Evidence map›Paper›PMID 34587483›Full record

ReviewChest2022

Acute Management of High-Risk and Intermediate-Risk Pulmonary Embolism in Children: A Review.

Catherine Ross, Riten Kumar, Marie-Claude Pelland-Marcotte, Shivani Mehta, Monica E Kleinman, Ravi R Thiagarajan, Muhammad B Ghbeis, Christina J VanderPluym, Kevin G Friedman, Diego Porras and 3 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Chest, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Guideline
  3. Article
  4. Catheter Thrombectomy of Massive Pulmonary Embolism Secondary to Spongostan Embolisation: A Case Report.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026
    Article
  5. Review
  6. Article
  7. Development, Implementation, and Evaluation of a Pediatric Pulmonary Embolism Clinical Pathway and Pulmonary Embolism Response Team.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2025
    Observational
  8. Article
  9. Review
  10. Article
  11. Article
  12. Review
  13. Article
  14. Article
  15. Article
  16. Case Report: RefractoryFrontiers in pediatrics · 2025
    Article
  17. Review
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Catherine RossDivision of Medical Critical Care, Department of Pediatrics, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA; Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA. Electronic address: Catherine.ross@childrens.harvard.edu.
Riten KumarHarvard Medical School, Boston, MA; Department of Pediatrics, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA.
Marie-Claude Pelland-MarcotteDivision of Hematology/Oncology, Department of Pediatrics, CHU de Québec-Centre Mère Enfant-Soleil, Québec City, QC.
Shivani MehtaCenter for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA; College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY.
Monica E KleinmanDivision of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Ravi R ThiagarajanDivision of Cardiovascular Critical Care, Department of Cardiology, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Muhammad B GhbeisDivision of Cardiovascular Critical Care, Department of Cardiology, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Christina J VanderPluymDivision of Cardiovascular Critical Care, Department of Cardiology, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Kevin G FriedmanDepartment of Pediatric Cardiology, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Diego PorrasDivision of Invasive Cardiology, Department of Cardiology, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Francis Fynn-ThompsonDepartment of Cardiac Surgery, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Samuel Z GoldhaberHarvard Medical School, Boston, MA; Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Leonardo R BrandãoDepartment of Paediatrics, Haematology/Oncology Division, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

Funding

Epinephrine in the Pediatric Intensive Care Unit: A Dose-Effect TrialK23HL148312 · NHLBI · BOSTON CHILDREN'S HOSPITAL · PI ROSS, CATHERINE · 2020 to 2024
$1.0M
NHLBI NIH HHS K23 HL148312
6 · The paper itself

Abstract

Severe forms of pulmonary embolism (PE) in children, althought rare, cause significant morbidity and mortality. We review the pathophysiologic features of severe (high-risk and intermediate-risk) PE and suggest novel pediatric-specific risk stratifications and an acute treatment algorithm to expedite emergent decision-making. We defined pediatric high-risk PE as causing cardiopulmonary arrest, sustained hypotension, or normotension with signs or symptoms of shock. Rapid primary reperfusion should be pursued with either surgical embolectomy or systemic thrombolysis in conjunction with a heparin infusion and supportive care as appropriate. We defined pediatric intermediate-risk PE as a lack of systemic hypotension or compensated shock, but with evidence of right ventricular strain by imaging, myocardial necrosis by elevated cardiac troponin levels, or both. The decision to pursue primary reperfusion in this group is complex and should be reserved for patients with more severe disease; anticoagulation alone also may be appropriate in these patients. If primary reperfusion is pursued, catheter-based therapies may be beneficial. Acute management of severe PE in children may include systemic thrombolysis, surgical embolectomy, catheter-based therapies, or anticoagulation alone and may depend on patient and institutional factors. Pediatric emergency and intensive care physicians should be familiar with the risks and benefits of each therapy to expedite care. PE response teams also may have added benefit in streamlining care during these critical events.

Indexed as

Pulmonary EmbolismThrombolytic TherapyAcute DiseaseChildEmbolectomyHumansRisk FactorsTreatment Outcomeanticoagulationpediatric pulmonary embolismsurgical embolectomythrombolysis

Identifiers

PMID34587483
PMCPMC8941619

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.