Kosin Med J.  2018 Dec;33(3):477-482. 10.7180/kmj.2018.33.3.477.

A case of rescuing a patient with acute cardiovascular instability from sudden and massive intraoperative pulmonary thromboembolism by extracorporeal membrane oxygenation

Affiliations
  • 1Department of Anesthesiology & pain medicine, Dongtan sacred heart hospital, Hwaseong, Korea. wj131@hallym.or.kr

Abstract

Intraoperative pulmonary thromboembolism is a high mortality situation. Early mortality in patients with pulmonary thromboembolism varies from 2% in normotensive patients to 30% in patients with cardiogenic shock. The use of extracorporeal cardiopulmonary resuscitation can improve survival and neurologic outcomes of cardiac arrest. We report a case of intraoperative massive pulmonary thromboembolism with circulatory collapse and cardiac arrest during anesthesia for pelvic bone fracture surgery, which were rescued by extracorporeal membrane oxygenation.

Keyword

Extracorporeal life support; Extracorporeal membrane oxygenation; Pulmonary thromboembolism

MeSH Terms

Anesthesia
Cardiopulmonary Resuscitation
Extracorporeal Membrane Oxygenation*
Heart Arrest
Humans
Mortality
Pelvic Bones
Pulmonary Embolism*
Shock
Shock, Cardiogenic

Figure

  • Fig. 1 Transthoracic echocardiography showed distended right ventricle and D shaped left ventricle.

  • Fig. 2 Chest computed tomography scan showed massive pulmonary thromboembolism at right and left main pulmonary arteries.

  • Fig. 3 Chest computed tomography scan showed resolved pulmonary thromboembolism 13 days after operation.


Reference

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3. Chana-Rodríguez F, Mañanes RP, Rojo-Manaute J, Haro JA, Vaquero-Martín J. Methods and Guidelines for Venous Thromboembolism Prevention in Polytrauma Patients with Pelvic and Acetabular Fractures. Open Orthop J. 2015; 9:313–320.
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Article
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