Cardiac arrest due to massive pulmonary embolism following caesarean section. Successful resuscitation and pulmonary embolectomy.
A woman developed pulmonary embolism with cardiac arrest after caesarean section. Cardiopulmonary resuscitation was performed for 45 min during which echocardiography showed right ventricular dilatation. After stabilization, but still in a critical condition, the patient was transferred by airambulance to a hospital with facilities for extracorporeal circulation. A massive embolus was removed. Some hours after extubation the patient developed respiratory insufficiency and hypovolaemia. Re-intubation was followed by severe hypotension requiring external cardiac compression for about 15 min. An emergency explorative laparotomy revealed a ruptured liver with a subcapsular haematoma. A critical illness polyneuropathy made prolonged ventilatory support necessary. She recovered without cerebral sequelae.
Ilsaas
C
C
Department of Anaesthesiology, Rogaland Central Hospital, Stavanger, Norway.
Husby
P
P
Koller
M E
ME
Segadal
L
L
Holst-Larsen
H
H
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D017128:Embolectomy; D005260:Female; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000150:complications* / Q000601:surgery; D012151:Resuscitation