Extracorporeal membrane oxygenation after pulmonary embolectomy – A case report

S Kilwinger,J.G Van Der Hoeven

doi:10.15761/ccrr.1000144

Abstract

Massive pulmonary embolism (PE) is a life-threatening condition. Extracorporeal Life Support (ECLS) may be used for cardiopulmonary support, either as a bridge to surgical embolectomy or postoperative until cardiopulmonary recovery. We present a 35-year-old male suffering from massive PE who underwent surgical embolectomy and needed cardiopulmonary support for 6 days. Despite a complicated course, the patient recovered completely and was discharged home 36 days after admission. We review the existing literature regarding the use of ECLS in patients with massive PE.

Highlights

Massive pulmonary embolism (PE) is associated with a high mortality rate
In the International Cooperative Pulmonary Embolism Registry (ICOPER), 2454 patients with acute PE were registered to establish a 90 days all-cause mortality rate and identify factors associated with death [1]
On admission his vital signs were: blood pressure (BP) 109/72 mmHg, heart rate (HR) 122 bpm, SpO2 of 89% without supplemental oxygen increasing towards 98% after administering 6 liters of oxygen

Summary

Introduction

Massive pulmonary embolism (PE) is associated with a high mortality rate. In the International Cooperative Pulmonary Embolism Registry (ICOPER), 2454 patients with acute PE were registered to establish a 90 days all-cause mortality rate and identify factors associated with death [1]. The American Heart Association [3] defined massive PE as acute PE with sustained hypotension Risk factors for mortality with acute PE are: age >70 years, cancer, clinical congestive heart failure, chronic obstructive pulmonary disease, systemic arterial hypotension (systolic blood pressure 20 breaths/min) and RV hypokinesis [1]. Catheter embolectomy or surgical embolectomy may be considered for patients with submassive acute PE who show clinical evidence of adverse prognosis [3]

Case history

Findings

Discussion