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KMID : 1100620150020030193
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Clinical and Experimental Emergency Medicine
2015 Volume.2 No. 3 p.193 ~ p.196
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Successful fibrinolytic and therapeutic hypothermic management of cardiac arrest following massive pulmonary embolism
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Ko Eun-Sil
Lee Jeong-Hoon
Minjung Kathy Chae
Lee Tae-Rim
Sim Min-Seob
Shin Tae-Gun
Cha Won-Chul
Jo Ik-Joon
Song Keun-Jeong
Rhee Joong-Eui
Jeong Yeon-Kwon
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Abstract
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Massive pulmonary embolism (MPE) with hemodynamic instability is a clinical condition with a poor prognosis and high mortality rates. There are no definitive treatment options for cardiac arrest due to MPE. A 52-year-old female presented at our emergency department with cardiac arrest, and a 62-year-old female presented after achieving return of spontaneous circulation of cardiac arrest from a local hospital, respectively. In each case, computed tomographic pulmonary angiography after return of spontaneous circulation demonstrated heavy burdens of pulmonary embolism in the pulmonary arteries. We immediately started therapeutic hypothermia and fibrinolytic therapy. They were transferred to the thoracic surgery and cardiology departments respectively, and then discharged with a cerebral performance categories scale score of 1. In summary, we report two cases of out-of-hospital cardiac arrest due to MPE in which fibrinolytic therapy was successfully combined with therapeutic hypothermia.
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KEYWORD
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Heart arrest, Fibrinolysis, Pulmonary embolism, Hypothermia, induced
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