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Patients with high-risk PE are often critically ill, with complex underlying physiology, and treatment for the high-risk PE patient almost always requires care and management from an intensivist. Treatment options for high-risk PE continue to evolve rapidly with multiple options for definitive reperfusion therapy and supportive care. A thorough understanding of the physiology, risk stratification, treatment, and support options for the high-risk PE patient is necessary for all intensivists in order to improve outcomes. This article aims to provide a review from an intensivist's perspective highlighting the physiological consequences, risk stratification, and treatment options for these patients as well as providing a proposed algorithm to the risk stratification and acute management of high-risk PE.<\/jats:p>","DOI":"10.1177\/08850666231188290","type":"journal-article","created":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T00:06:05Z","timestamp":1689552365000},"page":"1087-1098","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["High-Risk Pulmonary Embolism: Management for the Intensivist"],"prefix":"10.1177","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2915-2369","authenticated-orcid":false,"given":"Akhil","family":"Khosla","sequence":"first","affiliation":[{"name":"Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, Yale New Haven Hospital, New Haven, CT, 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