Friday, June 12, 2015

Harnessing the power of PERT

Kearn Kawai with her daughter, Ava

In an instant, Kerry Kearn Kawai’s life completely changed. In 2011, the 34-year-old lawyer was preparing for the day – and for motherhood – when she collapsed in her kitchen, suffering a massive pulmonary embolism (PE), a life-threatening blood clot in the lung. She was rushed to an area hospital, where doctors were forced to prematurely deliver her child at 26 weeks, then quickly transferred to another facility to extract the problematic clot.

Due to the severity of her case, Kearn Kawai was then transferred to the MGH, under the care of 
Ken Rosenfield, MD, section head of Vascular Medicine and Intervention in the Division of Cardiology. 
After receiving a transfusion of 120 units of blood, undergoing multiple surgical procedures, and spending almost two weeks on extracorporeal membrane oxygenation (ECMO) – which provides both cardiac and respiratory life support – she embarked on a nearly four-year road to recovery. Kearn Kawai shared this journey during a May 22 scientific symposium, “Pulmonary Embolism: What Is Known, What We Need To Know” at the Wyndham Boston Beacon Hill.

More than 150 people attended the event – hosted by the MGH Pulmonary Embolism Response Team (PERT), 
the MGH Fireman Vascular Center, the MGH Corrigan Minehan Heart Center and Partners HealthCare – to discuss improvements in PE detection, care coordination and patient management.

The symposium was a result of years of hard work by 
the PERT, formed in 2012 by a group of MGH physicians – 
including Rosenfield, Michael Jaff, DO, and Ido Weinberg, MD, 
both of the Fireman Vascular Center; Richard Channick, MD, 
of Pulmonary/Critical Care Medicine; Thoralf Sundt, MD, of Cardiac Surgery; Christopher Kabrhel, MD, of Emergency Medicine; and Rachel Rosovsky, MD, of Hematology. Following a number of national speaking engagements and published articles featuring the highly successful experience of the MGH team, the PERT concept has gained widespread interest with many centers around the country setting up similar teams.

“We decided to create a national consortium where we could harness ‘the power of PERT’ to share data, develop research protocols, establish practice guidelines, and work together collaboratively to enhance the care and improve outcomes in our patients with PE,” said Rosenfield. “There seems to be a great demand for education, research and advancement in this field, but we are most excited about the prospect for improving the care of patients with this terrible disease. PE is an entity that kills tens of thousands every year.”

Attendees from throughout the United States gathered at the inaugural symposium to discuss how to further the field through the exchange of best practices, the establishment of an infrastructure for collaborative research and the development of a roadmap for future research.

“Imagine if we can get a group of dedicated health care providers to collaborate on investigating novel approaches to the management of PE, and we collect the data on outcomes and complications,” said Jaff. “We will learn more about PE in one or two years than over the past 
20 years combined.”

While the long-term effects of PE can be poorly understood – the condition’s often debilitating aftereffects are not measured by current high-quality outcomes data and evaluation tools – the symposium’s founders believe a national group of experts focused on furthering education and research would drive advancements in patient care.

“In our institution alone, no fewer than 200 patients per year have a large pulmonary embolism. It is one of the most common and important illnesses in our society, and yet one of the most neglected,” said Rosenfield. “Through these newly established relationships, we are forging partnerships with leading academic partners to better understand, treat and develop interventions for PE sufferers in Boston and throughout the country.”





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