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Management of intraoperative acute pulmonary embolism in a patient with subarachnoid haemorrhage undergoing femoral fracture repair

Acute pulmonary embolism (APE) during surgery can be life-threatening. We herein report a case of a 56-year-old man with subarachnoid haemorrhage who underwent surgical repair of a femoral fracture. During surgery with the patient under general anaesthesia, his oxygen saturation and end-tidal carbon...

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Autores principales: Aiping, Yang, Shuangyin, Zhang, Yanhong, Xing, Rongzhi, Zhang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6833381/
https://www.ncbi.nlm.nih.gov/pubmed/31552755
http://dx.doi.org/10.1177/0300060519874158
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author Aiping, Yang
Shuangyin, Zhang
Yanhong, Xing
Rongzhi, Zhang
author_facet Aiping, Yang
Shuangyin, Zhang
Yanhong, Xing
Rongzhi, Zhang
author_sort Aiping, Yang
collection PubMed
description Acute pulmonary embolism (APE) during surgery can be life-threatening. We herein report a case of a 56-year-old man with subarachnoid haemorrhage who underwent surgical repair of a femoral fracture. During surgery with the patient under general anaesthesia, his oxygen saturation and end-tidal carbon dioxide decreased dramatically. An emergency transoesophageal echocardiogram demonstrated mobile echogenic densities in the right pulmonary artery and enlargement of the right atrium, and these findings were suggestive of APE. Considering the patient’s history of subarachnoid haemorrhage, anticoagulation with heparin or thrombolysis therapy for APE was contraindicated. We recommended inferior vena cava filter placement to prevent recurrence of the APE. Unfortunately, the patient and his family members refused the filter implantation, and the patient was discharged.
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spelling pubmed-68333812019-11-13 Management of intraoperative acute pulmonary embolism in a patient with subarachnoid haemorrhage undergoing femoral fracture repair Aiping, Yang Shuangyin, Zhang Yanhong, Xing Rongzhi, Zhang J Int Med Res Case Reports Acute pulmonary embolism (APE) during surgery can be life-threatening. We herein report a case of a 56-year-old man with subarachnoid haemorrhage who underwent surgical repair of a femoral fracture. During surgery with the patient under general anaesthesia, his oxygen saturation and end-tidal carbon dioxide decreased dramatically. An emergency transoesophageal echocardiogram demonstrated mobile echogenic densities in the right pulmonary artery and enlargement of the right atrium, and these findings were suggestive of APE. Considering the patient’s history of subarachnoid haemorrhage, anticoagulation with heparin or thrombolysis therapy for APE was contraindicated. We recommended inferior vena cava filter placement to prevent recurrence of the APE. Unfortunately, the patient and his family members refused the filter implantation, and the patient was discharged. SAGE Publications 2019-09-25 2019-10 /pmc/articles/PMC6833381/ /pubmed/31552755 http://dx.doi.org/10.1177/0300060519874158 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Reports
Aiping, Yang
Shuangyin, Zhang
Yanhong, Xing
Rongzhi, Zhang
Management of intraoperative acute pulmonary embolism in a patient with subarachnoid haemorrhage undergoing femoral fracture repair
title Management of intraoperative acute pulmonary embolism in a patient with subarachnoid haemorrhage undergoing femoral fracture repair
title_full Management of intraoperative acute pulmonary embolism in a patient with subarachnoid haemorrhage undergoing femoral fracture repair
title_fullStr Management of intraoperative acute pulmonary embolism in a patient with subarachnoid haemorrhage undergoing femoral fracture repair
title_full_unstemmed Management of intraoperative acute pulmonary embolism in a patient with subarachnoid haemorrhage undergoing femoral fracture repair
title_short Management of intraoperative acute pulmonary embolism in a patient with subarachnoid haemorrhage undergoing femoral fracture repair
title_sort management of intraoperative acute pulmonary embolism in a patient with subarachnoid haemorrhage undergoing femoral fracture repair
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6833381/
https://www.ncbi.nlm.nih.gov/pubmed/31552755
http://dx.doi.org/10.1177/0300060519874158
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