KMID : 0604020080230020111
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Korean Journal of Critical Care Medicine 2008 Volume.23 No. 2 p.111 ~ p.114
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Management of Pulmonary Thromboembolism with Inferior Vena Cava Filter
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Jang Yeon
Song Ho-Kyung Chin Yun-Sun Jung Hyun-Seok
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Abstract
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We managed a case in which an inferior vena cava filter was inserted for a pulmonary thromboembolism that occurred during general anesthesia. A 71-year-old woman was prepped for reduction of a distal femur fracture and arthroplastic surgery. Her initial vital signs were stable, but the end-tidal CO2 and SaO2 were decreased gradually after application of the tourniquet for surgery. Because of impaired ventricular wall motion and a dilated inferior vena cava on echocardiogram, we suspected a pulmonary thromboembolism. Thus, we inserted an inferior vena cava filter percutaneously under propofol sedation in the Radiology Department. In addition to ventilatory support and hemodynamic management, heparin was administered as anticoagulant therapy postoperatively in the intensive care unit. Multiple thrombi in the pulmonary artery were confirmed on chest CT. On the 4th postoperative day, she was transferred to the general ward without any complications.
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KEYWORD
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perioerative, pulmonary thromboembolism, inferior vena vana filter
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