A case of acute massive pulmonary thromboembolism one week after the fracture of the supine

DOI 7 References
  • Kadoi Yuji
    <I>Department of Intensive Care, Gunma University, School of Medicine</I>
  • Kunimoto Fumio
    <I>Department of Intensive Care, Gunma University, School of Medicine</I>
  • Saito Shigeru
    <I>Department of Anesthesiology and Reanimatology, Gunma University, School of Medicine</I>
  • Goto Fumio
    <I>Department of Anesthesiology and Reanimatology, Gunma University, School of Medicine</I>

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  • 離床時に発生した急性肺血栓塞栓症の１症例

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Abstract

We reported a case of acute pulmonary thromboembolism one week after the fractureof the supine. A 78-year women had a sudden severe dyspnea one week after the fracture. A massive pulmonary thromboembolism was suspected by her clinical features with decreased SpO2 (60%) and hypotension ( <60 mmHg) . Immediate pulmonary angiography confirmed a massive pulmonary thromboembolism. Since mechanical thromboectomy failed to remove thrombosis, tissue plasminogen activator (t-PA, 24 million unit) was infused to pulmonary artery. Cardiac arrest was occurred during this procedure, then percutaneous cardiopulmonary bypass support system (PCPS) was performed.<BR>Herhemodynamics and oxygenation were immediately recovered after PCPS. Pulmonary angiography 2 days after this episode showed decrease of pulmonary thromboembolism. IABP and PCPS were useful to maintain hemodynamic in patiens with a massive pumonary thromboembolism.

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