Korean J Med.  2015 Aug;89(2):210-214. 10.3904/kjm.2015.89.2.210.

Two Cases of Treatment with Thrombolysis and an Extracorporeal Membrane Oxygenator in Patients with Pulmonary Embolism and Cardiac Arrest

• Moon IT
• Sohn YS
• Yeo JH
• Lee DH
• Lee HY
• Kim SG
• Shin JH

• KMID: 2269031
• DOI: http://doi.org/10.3904/kjm.2015.89.2.210

Abstract

Massive pulmonary embolism (PE) is associated with poor prognosis and high mortality. Moreover, patients with massive PE who present with shock have mortality rates ranging from 30% to 50%. Thrombolysis should be administered to patients with massive PE unless there are absolute contraindications to its use. However, treatment failure still occurs, and there is no consensus for the management of massive PE with cardiopulmonary arrest with regard to thrombolysis. In this study, two cases of massive PE with cardiopulmonary arrest are described, both of which were successfully treated with thrombolysis and hemodynamic support, which was administered by extracorporeal membrane oxygenation (ECMO). This report suggests that ECMO may provide safe and adequate cardiopulmonary support in patients with massive PE with refractory thrombolysis and cardiopulmonary arrest.

Keyword

Pulmonary embolism; Extracorporeal membrane oxygenation; Thrombolytic therapy; Heart arrest

MeSH Terms

Consensus
Extracorporeal Membrane Oxygenation
Heart Arrest*
Hemodynamics
Humans
Membranes*
Mortality
Oxygenators, Membrane*
Prognosis
Pulmonary Embolism*
Shock
Thrombolytic Therapy
Treatment Failure