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...

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Bibliographic Details
Published in:The American journal of emergency medicine 2015-10, Vol.33 (10), p.1545.e1-1545.e2
Main Authors: Jeong, Won Joon, MD, Lee, Jun Wan, MD, Yoo, Youn Ho, MD, Ryu, Seung, MD, Cho, Sung Wook, MD, Song, Kyoung Hyuk, MD, Park, Sang Il, MD
Format: Article
Language:English
Subjects:
Biopsy
Cardiopulmonary Resuscitation
CPR
Echocardiography
Embolisms
Emergency
Emergency medical care
Evacuations & rescues
Extracorporeal Membrane Oxygenation
Female
Heart attacks
Hospitalization
Humans
Lymphoma
Lymphoma, B-Cell - complications
Lymphoma, B-Cell - diagnosis
Middle Aged
Mortality
Patients
Point-of-Care Systems
Pulmonary Embolism - diagnostic imaging
Pulmonary Embolism - etiology
Pulmonary Embolism - therapy
Syncope
Tomography, X-Ray Computed
Ultrasonic imaging
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Summary: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.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2015.07.026