Management of perioperative acute massive pulmonary embolism: A case series

Kim, Jiyoon; Lee, Young‐Seok; Park, Hyun Oh; Shin, Il Woo

doi:10.1002/ccr3.4078

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…Hence, its early diagnosis and treatment are important for saving the patient’s life, 10 and the disease should be considered as one of the possible differential diagnoses in cases with unexplained changes in hemodynamics and oxygenation perioperatively, as in this case. In addition, while there are several reports of PTE in the perioperative period that were treated with anticoagulation, 1 , 10 , 11 there are only a few reports of its surgical treatment. Therefore, this case is significant to report.…”

Section: Discussionmentioning

confidence: 99%

Case of intraoperative acute pulmonary embolism diagnosed by transesophageal echocardiography under general anesthesia and successfully managed with extracorporeal membrane oxygenation

Kurachi

Ishida

2023

SAGE Open Medical Case Reports

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Acute pulmonary thromboembolism (PTE), which carries a high mortality rate, is difficult to diagnose when it occurs intraoperatively. Therefore, patient prognosis depends on a prompt diagnosis by anesthesiologists. A 49-year-old woman underwent right lower extremity dissection due to a contusion of the right lower extremity caused by trauma. Eleven days after surgery, she underwent debridement for necrosis of the amputation wound. Intraoperatively, a drop in blood pressure and tachycardia were observed, and PTE was suspected based on a rapid deterioration in oxygen saturation and a drop in end-tidal carbon dioxide partial pressure. Transesophageal echocardiography (TEE) showed a thrombus filling the right pulmonary artery, and a diagnosis of PTE was made. The patient was treated using venoarterial extracorporeal membrane oxygenation, and thrombectomy was performed the next day to save her life. In this case, we were able to diagnose and treat the intraoperative acute PTE at an early stage. In addition, the appropriate choice of treatment saved the patient’s life without complications.

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Section: Discussionmentioning

confidence: 99%

Case of intraoperative acute pulmonary embolism diagnosed by transesophageal echocardiography under general anesthesia and successfully managed with extracorporeal membrane oxygenation

Kurachi

Ishida

2023

SAGE Open Medical Case Reports

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“…[15] Other studies presented twelve cases of intracranial hemorrhage in a PTE patient who received thrombolytic therapy, while no intracranial hemorrhage occurred in a PTE patient who did not receive thrombolytic therapy. [16][17][18] To choose the best course of thrombolysis, the clinician must weigh the benefits to the patient after thrombolysis against the potential disadvantages of bleeding risk.…”

Section: Discussionmentioning

confidence: 99%

Successful cardiopulmonary resuscitation combined with thrombolysis for massive pulmonary embolism during peri-cardiac arrest

Li¹

2022

World Journal of Emergency Medicine

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“…Therefore, the choice of treatment depends on the patient's clinical status, bleeding risk, local expertise, and available devices [5,11,12]. In cases where ROSC cannot be achieved after initial chest compression, ECMO (extracorporeal membrane oxygenation) plays a crucial role as a bridging therapy before thrombolysis [13,14].…”

Section: Fig-3mentioning

confidence: 99%

Acute Massive Pulmonary Embolism During Craniotomy: A Case Report

Wang

Yang

et al. 2023

Asp Biomed Clin Case Rep

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Background: Venous thrombosis is a common complication among critically ill patients with intracerebral hemorrhage, which may lead to pulmonary embolism. Case Presentation: In this report, we present a case of a man who was diagnosed with left basal ganglia region hemorrhage, hypertension, and venous thromboembolism. Considering the risks, including rebleeding and the expansion of the hematoma, he did not receive any anticoagulation after onset. The thrombus located in the pulmonary artery was found by transesophageal echocardiography after he suffered cardiac arrest during the craniotomy. Additionally, a thrombus attached to the central venous catheter was observed by ultrasound. Unfortunately, he died of PE without receiving any effective treatment. Conclusions: This case emphasizes the importance of prophylactic and therapeutic strategies for thromboembolic events among critically ill populations. It also underscores the critical role of perioperative ultrasound.

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Management of perioperative acute massive pulmonary embolism: A case series

Abstract: The management of acute massive pulmonary embolism during the perioperative period is challenging. Accurate diagnosis using echocardiography and application of rapid extracorporeal membrane oxygenation can improve patients' outcomes.

Cited by 5 publications

References 18 publications

Case of intraoperative acute pulmonary embolism diagnosed by transesophageal echocardiography under general anesthesia and successfully managed with extracorporeal membrane oxygenation

Case of intraoperative acute pulmonary embolism diagnosed by transesophageal echocardiography under general anesthesia and successfully managed with extracorporeal membrane oxygenation

Successful cardiopulmonary resuscitation combined with thrombolysis for massive pulmonary embolism during peri-cardiac arrest

Acute Massive Pulmonary Embolism During Craniotomy: A Case Report

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