Extracorporeal cardiopulmonary resuscitation in bedside echocardiography-diagnosed massive pulmonary embolism.
Acute pulmonary embolism (PE) is one of the major causes of inhospital cardiac arrest as well as out-of-hospital cardiac arrest. Bedside diagnosis of acute PE in the emergency department (ED) can be challenging, especially in a cardiac arrest setting. Even if the early diagnosis of an acute massive PE had been made, hemodynamic instability may be worsened unless obstructive shock gets resolved. We present a case of a 46-year-old woman who developed pulseless electrical activity (PEA) after complaining of weakness and dyspnea in an ambulance, presumptively diagnosed as acute PE by bedside focused echocardiography. She received thrombolytic therapy and was rescued by extracorporeal cardiopulmonary resuscitation for recurrent PEA arrest in the ED. Focused bedside echocardiography provides a rapid diagnostic adjunct, and extracorporeal cardiopulmonary resuscitation can be a valuable rescue therapy for PEA arrest from massive PE.
Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea.
Won Joon
WJ
Jeong
Emergency ICU, Regional Emergency Center, Chungnam National University Hospital, Daejeon, Republic of Korea. Electronic address: u2lee@hanmail.net.
Jun Wan
JW
Lee
Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea.
Youn Ho
YH
Yoo
Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea.
Seung
S
Ryu
Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea.
Sung Wook
SW
Cho
Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea.
Kyoung Hyuk
KH
Song
Department of Anesthesiology, Chungnam National University Hospital, Daejeon, Republic of Korea.
Sang Il
SI
Park
D001706:Biopsy; D016887:Cardiopulmonary Resuscitation; D004452:Echocardiography; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D019095:Point-of-Care Systems; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000628:therapy*; D013575:Syncope; D014057:Tomography, X-Ray Computed