Extracorporeal Life Support as Salvage Therapy for Massive Pulmonary Embolus and Cardiac Arrest in Pregnancy

Michael E Takacs; Kristina E Damisch

doi:10.1016/j.jemermed.2018.04.009

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Extracorporeal Life Support as Salvage Therapy for Massive Pulmonary Embolus and Cardiac Arrest in Pregnancy

Journal article

Peer reviewed

Extracorporeal Life Support as Salvage Therapy for Massive Pulmonary Embolus and Cardiac Arrest in Pregnancy

Michael E Takacs and Kristina E Damisch

The Journal of emergency medicine, Vol.55(1), pp.121-124

07/2018

DOI: 10.1016/j.jemermed.2018.04.009

PMID: 29739630

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Abstract

Massive pulmonary embolus (PE) with prolonged cardiac arrest in the setting of pregnancy has few treatment options. Selections are further restricted if there are contraindications to the standard therapies of embolectomy and thrombolysis. We report a case of extracorporeal life support (ECLS) used as salvage therapy for a critically ill pregnant patient. A 21-year-old woman presented to a small rural hospital with chest pain, dyspnea, hypoxia, and syncope. In their emergency department, she suffered 2 episodes of cardiac arrest requiring cardiopulmonary resuscitation, and fetal demise followed. A computed tomography scan revealed a saddle PE. She was transferred to our tertiary care hospital and arrived critically ill, on multiple vasopressors, and in cardiogenic shock. Because standard treatments, namely thrombolysis and embolectomy, were contraindicated in this case, ECLS was employed for 7 days. She was discharged home after 23 days, and at follow-up 5 months after her admission, she was found to have made a near-complete recovery. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: ECLS is a viable option as salvage therapy for pregnant patients with massive PE who have contraindications to thrombolysis and embolectomy.

Emergency Service, Hospital - organization & administration

Extracorporeal Membrane Oxygenation - methods

Female

Heart Arrest - etiology

Heart Arrest - therapy

Humans

Pregnancy

Pulmonary Embolism - complications

Pulmonary Embolism - therapy

Salvage Therapy - methods

Syncope - etiology

Young Adult

Details

Title: Subtitle: Extracorporeal Life Support as Salvage Therapy for Massive Pulmonary Embolus and Cardiac Arrest in Pregnancy
Creators: Michael E Takacs - University of Iowa
Kristina E Damisch - University of Iowa
Resource Type: Journal article
Publication Details: The Journal of emergency medicine, Vol.55(1), pp.121-124
DOI: 10.1016/j.jemermed.2018.04.009
PMID: 29739630
NLM abbreviation: J Emerg Med
ISSN: 0736-4679
eISSN: 2352-5029
Publisher: Elsevier Inc
Language: English
Date published: 07/2018
Academic Unit: Emergency Medicine
Record Identifier: 9984297136002771

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