Principles of management options of right ventricular failure in pulmonary embolism
| Management of the thrombus | Management of the preload | Pharmacologic support | Mechanical support |
|---|---|---|---|
| High-risk pulmonary embolism: intravenous thrombolytics vs surgical embolectomy | Volume assessment | First line: norepinephrine | Venoarterial extracorporeal membrane oxygenation |
| Intermediate-risk pulmonary embolism: catheter-guided therapies (thrombolysis or thrombectomy) vs anticoagulation alone | Fluid challenge vs intravenous furesomide | Second line: dobutamine | Right ventricular assist device |
| Inferior caval vein filter placement as an adjunct to above, especially if contraindications to anticoagulation |
Based on information from references 7 and 10.