Successful use of a new hand-held ECMO system in cardiopulmonary failure and bleeding shock after thrombolysis in massive post-partal pulmonary embolism.
Massive pulmonary embolism (PE) leads to cardiogenic shock and is associated with mortality rates of up to 75%. We report on a 27-year-old mother in childbirth who developed a massive post-partal PE and cardiac arrest. Despite mechanical resuscitation, return of spontaneous circulation (ROSC) could not be achieved. After systemic thrombolysis, ROSC returned, but cardiopulmonary failure was persisting, complicated by massive bleeding shock. By using a newly developed, hand-held ECMO system, systemic blood flow and oxygenation were restored and emergency medical services for advanced surgical treatment (hysterectomy and pulmonary embolectomy) were possible. The patient recovered completely. We assume that this newly developed hand-held ECMO device enables rapid onset mechanical life support and improves the prognosis of patients in fatal conditions.
Arlt
M
M
Department of Anesthesiology, Air-Medical Service, University Hospital Regensburg, Regensburg, Germany. matthias.arlt@klinik.uni-regensburg.de
Philipp
A
A
Iesalnieks
I
I
Kobuch
R
R
Graf
B M
BM
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D017128:Embolectomy; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000601:surgery*; D006470:Hemorrhage / Q000150:complications / Q000209:etiology / Q000601:surgery; D006801:Humans; D007044:Hysterectomy; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000209:etiology* / Q000601:surgery*; D015912:Thrombolytic Therapy