Massive pulmonary embolism leading to cardiac arrest: one pathology, two different ECMO modes to assist patients.
J Clin Monit Comput
; 30(6): 933-937, 2016 Dec.
Article
em En
| MEDLINE
| ID: mdl-26497976
ABSTRACT
Massive acute pulmonary embolism (MAPE) represents a significant risk for morbidity and mortality. The potential for sudden and fatal deterioration highlights the need for a prompt diagnosis and appropriate intervention. Using two cases reports, we describe two different modes of successful ECMO implantation (VA-ECMO vs. VV-ECMO) for MAPE leading to cardiac arrest. A 27-year-old patient with a severe trauma presented with a MAPE leading to cardiac arrest. In this case, which had absolute contraindications of thrombolysis, a VA-ECMO was successfully implanted. Additionally, a 56-year-old patient presented with a MAPE leading to cardiac arrest. Although intravenous thrombolysis allowed for hemodynamic stabilization, the patient remained severely hypoxemic with RV dilation. A VV-ECMO was successfully implemented, leading to a rapid improvement in both oxygenation and RV function. ECMO can provide lifesaving hemodynamic and respiratory support in critically ill patients with a MAPE who are too unstable to tolerate other interventions or have failed other therapies. An important determinant of success in the use of ECMO for MAPE is the return of adequate RV function, which allows physicians to appropriately identify which type of ECMO to implant.
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Bases de dados:
MEDLINE
Assunto principal:
Embolia Pulmonar
/
Oxigenação por Membrana Extracorpórea
/
Parada Cardíaca
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Clin Monit Comput
Assunto da revista:
INFORMATICA MEDICA
/
MEDICINA
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
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