title: Cardiac arrest due to massive pulmonary embolism following caesarean section. Successful resuscitation and pulmonary embolectomy.
abstract: 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.
authors.affiliation: Department of Anaesthesiology, Rogaland Central Hospital, Stavanger, Norway.
authors.forename: C
authors.initials: C
authors.lastname: Ilsaas
authors.forename: P
authors.initials: P
authors.lastname: Husby
authors.forename: M E
authors.initials: ME
authors.lastname: Koller
authors.forename: L
authors.initials: L
authors.lastname: Segadal
authors.forename: H
authors.initials: H
authors.lastname: Holst-Larsen
mesh_terms: 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