Treatment of massive pulmonary embolism utilizing a multidisciplinary approach: a case study
2009; SAGE Publishing; Volume: 24; Issue: 3 Linguagem: Inglês
10.1177/0267659109346663
ISSN1477-111X
AutoresKevin E. Griffith, Eric Jenkins, Jonathan W. Haft,
Tópico(s)Central Venous Catheters and Hemodialysis
ResumoMassive pulmonary embolism (PE) is associated, historically, with a high mortality rate.Treatment options include systemic anticoagulation, catheter-directed thrombolytic therapy, surgical embolectomy, fragmentation techniques, and catheter embolectomy. Extracorporeal membrane oxygenation (ECMO) repeatedly has demonstrated effectiveness in providing cardiopulmonary support for the patient with a massive PE too unstable to undergo thrombolysis or embolectomy. The present case study describes a morbidly obese patient, status post gastric bypass surgery, who presented with PE, and acute respiratory and cardiac failure. A description of the patient’s management plan, which includes a simple, rapidly deployed ECMO system (Levitronix ® CentriMag ® and Jostra Quadrox D), systemic- and catheter-directed thrombolytic therapy and rheolytic thrombectomy (AngioJet ® Series 3000, Possis Medical, Minneapolis, MN).
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