Hestia criteria for pulmonary embolism treatment
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When to use
Hemodynamically unstable systolic blood pressure < 100 mmHg with heart rate > 100/need for ICU admission/by clinician judgment)
No
Yes
Need for thrombolysis or embolectomy
No
Yes
Active bleeding or high risk for bleeding GI bleeding < 2 weeks, stroke < 4 weeks, recent surgery < 2 weeks, bleeding disorder or thrombocytopenia, uncontrolled hypertension)
No
Yes
> 24 hours on supplemental oxygen to maintain SaO2 > 90%
No
Yes
Pulmonary embolism during anticoagulant treatment
No
Yes
Severe pain needing IV pain medication > 24 hours
No
Yes
Medical or social reason for treatment in hospital > 24 hours
No
Yes
Creatinine clearance < 30 mL/min by Cockcroft-Gault
No
Yes
Severe liver impairment
No
Yes
Pregnancy
No
Yes
Documented history of heparin-induced thrombocytopenia
No
Yes
Calculation
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