Abstract
Patients with pulmonary embolism leading to cardiac arrest usually have poor prognosis. Adequate treatment is essential.
Besides anticoagulant and thrombolytic therapy we can employ circulatory and ventilatory support, mechanical circulatory support like venoarterial extracorporeal membrane oxygenation (V-A ECMO) and surgical or catheter embolectomy. The use of these therapeutic modalities could be connected with specific complications.
We present a 17-year-old young man with out-of-hospital cardiac arrest where conventional resuscitation methods were not successful so patient was transported during ongoing cardiopulmonary resuscitation (CPR) to a regional ECMO centre. Bed-side echocardiography was very suspicious of pulmonary embolism.
Unfractioned heparin was applied and the ECMO support was initiated. Computed tomography verified extensive bilateral pulmonary embolism with right ventricle dilatation.
Patient's hemodynamic status was getting worse so thrombolysis was administered. Severe complications have occurred and led to repeated surgical interventions.
This case also demonstrates the necessity of multidisciplinary cooperation.