title: Resuscitation of prolonged cardiac arrest from massive pulmonary embolism by extracorporeal membrane oxygenation.
abstract: Extracorporeal cardiopulmonary resuscitation can be used as a rescue strategy in cases of prolonged cardiac arrest caused by massive pulmonary embolism. We present a case of a male patient who was in prolonged cardiac arrest following massive pulmonary embolism. Veno-arterial extracorporeal membrane oxygenation was initiated approximately 93 min after prolonged cardiopulmonary resuscitation. After resuscitation, bedside echocardiography and a chest computed tomography angiogram revealed a massive pulmonary embolism during extracorporeal membrane oxygenation support. The patient received transcatheter mechanical thrombectomy without haemodynamic instability in extracorporeal membrane oxygenation support. He was also treated with therapeutic hypothermia to improve neurological outcome. Renal replacement therapy for acute kidney injury was continued for 36 days. The patient was discharged at 60 days after admission with no serious complications. This case demonstrates that veno-arterial extracorporeal membrane oxygenation and therapeutic hypothermia are an effective treatment strategy for prolonged cardiac arrest caused by massive pulmonary embolism.
authors.affiliation: Department of Thoracic Surgery, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea.
authors.forename: Yun Seok
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea.
authors.forename: Wookjin
authors.initials: W
authors.lastname: Choi
authors.affiliation: Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea.
authors.forename: Jaecheol
authors.initials: J
authors.lastname: Hwang
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation; D004562:Electrocardiography; D015199:Extracorporeal Membrane Oxygenation; D006323:Heart Arrest / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D011655:Pulmonary Embolism / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery
keywords: Extracorporeal membrane oxygenation ; Pulmonary embolism; Therapeutic hypothermia 