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Original Article
- Pulmonary
- Use of extracorporeal membrane oxygenation in patients with acute high-risk pulmonary embolism: a case series with literature review
- You Na Oh, Dong Kyu Oh, Younsuck Koh, Chae-Man Lim, Jin-Won Huh, Jae Seung Lee, Sung-Ho Jung, Pil-Je Kang, Sang-Bum Hong
- Acute Crit Care. 2019;34(2):148-154. Published online May 31, 2019
- DOI: https://doi.org/10.4266/acc.2019.00500
- 7,229 View
- 219 Download
- 20 Web of Science
- 21 Crossref
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Abstract
PDF - Background
Although extracorporeal membrane oxygenation (ECMO) has been used for the treatment of acute high-risk pulmonary embolism (PE), there are limited reports which focus on this approach. Herein, we described our experience with ECMO in patients with acute high-risk PE.
Methods
We retrospectively reviewed medical records of patients diagnosed with acute highrisk PE and treated with ECMO between January 2014 and December 2018.
Results
Among 16 patients included, median age was 51 years (interquartile range [IQR], 38 to 71 years) and six (37.5%) were male. Cardiac arrest was occurred in 12 (75.0%) including two cases of out-of-hospital arrest. All patients underwent veno-arterial ECMO and median ECMO duration was 1.5 days (IQR, 0.0 to 4.5 days). Systemic thrombolysis and surgical embolectomy were performed in seven (43.8%) and nine (56.3%) patients, respectively including three patients (18.8%) received both treatments. Overall 30-day mortality rate was 43.8% (95% confidence interval, 23.1% to 66.8%) and 30-day mortality rates according to the treatment groups were ECMO alone (33.3%, n=3), ECMO with thrombolysis (50.0%, n=4) and ECMO with embolectomy (44.4%, n=9).
Conclusions
Despite the vigorous treatment efforts, patients with acute high-risk PE were related to substantial morbidity and mortality. We report our experience of ECMO as rescue therapy for refractory shock or cardiac arrest in patients with PE. -
Citations
Citations to this article as recorded by
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Baylor University Medical Center Proceedings.2023; 36(3): 314. CrossRef - Surgical Management and Mechanical Circulatory Support in High-Risk Pulmonary Embolisms: Historical Context, Current Status, and Future Directions: A Scientific Statement From the American Heart Association
Joshua B. Goldberg, Jay Giri, Taisei Kobayashi, Marc Ruel, Alexander J.C. Mittnacht, Belinda Rivera-Lebron, Abe DeAnda, John M. Moriarty, Thomas E. MacGillivray
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- Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest: an overview of current practice and evidence
Case Reports
- Thoracic Surgery
- Acute Peripheral Arterial Tumorous Embolism after Lung Cancer Surgery
- Yoohwa Hwang, Hyun Joo Lee, Young Tae Kim
- Korean J Crit Care Med. 2015;30(3):234-237. Published online August 31, 2015
- DOI: https://doi.org/10.4266/kjccm.2015.30.3.234
- 4,494 View
- 63 Download
-
Abstract
PDF
- Systemic tumor embolisms after pulmonary resections for malignancy are rare, but usually severe and sometimes fatal. Here, we report a case of a 70-year-old woman who underwent pulmonary resection for lung cancer and subsequently developed acute arterial occlusion of the lower extremities caused by a tumorous embolus.
- Successful Embolectomy of a Pulmonary Saddle Embolism Post-cesarean Section Complicated by Cardiac Arrest: A Case Report
- Jae Jun Lee, Jin Kim, Hyoung Soo Kim, Min Sun Kyung, Eu Sun Ro, Sung Mi Hwang, So Young Lim
- Korean J Crit Care Med. 2009;24(3):164-167.
- DOI: https://doi.org/10.4266/kjccm.2009.24.3.164
- 2,217 View
- 20 Download
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Abstract
PDF
- A 41-year-old female underwent an uneventful cesarean section, which was followed by a pulmonary saddle embolism complicated by cardiac arrest. This case shows that successful embolectomy is possible, despite a potentially lethal pulmonary saddle embolism, 34 cm in length, and intra-operative cardiopulmonary resuscitation. We report our case and discuss the anesthetic considerations based on the literature.
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