The use of ultrasonography to guide diagnosis and treatment in resuscitation in a case of arrest due to pulmonary embolism

Yıl 2023, Cilt: 5 Sayı: 1, 48 - 50, 29.01.2023

Agit Akgül

https://doi.org/10.46310/tjim.1069084

Öz

Pulmonary embolism is one of the reversible causes of death. Simultaneous diagnostic procedures are beneficial for successfully resuscitating patients brought to the emergency department as an arrest after pulmonary embolism. Ultrasonography is one of the few diagnostic procedures to be performed on an unstable patient during resuscitation and is a direct guide for treatment. We followed the passage of the thrombus from the inferior vena cava to the right atrium in the ultrasonography performed simultaneously with the resuscitation of the 76-year-old male patient who was brought to the hospital with arrest, and we started thrombolytic therapy simultaneously with resuscitation. Thrombus enlargement was observed in the right atrium. The patient who did not respond to resuscitation died. Although the causes of reversible arrest are known, there may be uncertainties in diagnostic procedures and treatment during resuscitation. Classical resuscitation practice may be insufficient to solve reversible problems such as pulmonary embolism. Although there are reservations about the inclusion of point-of-care ultrasound in resuscitation, it can play a life-saving role.

Anahtar Kelimeler

Pocus, arrest, ultrasonography, pulmonary embolism, resuscitation

Kaynakça

• Ávila-Reyes D, Acevedo-Cardona AO, Gómez-González JF, Echeverry-Piedrahita DR, Aguirre-Flórez M, Giraldo-Diaconeasa A. Point-of-care ultrasound in cardiorespiratory arrest (POCUS-CA): narrative review article. Ultrasound J. 2021 Dec 2;13(1):46. doi: 10.1186/s13089-021-00248-0.
• Laher AE, Moolla M, Motara F, Paruk F, Richards G. Survival after Cardiac Arrest Secondary to Massive Pulmonary Embolism. Case Rep Emerg Med. 2018 Jan 31;2018:8076808. doi: 10.1155/2018/8076808.
• Stein PD, Matta F, Hughes PG, Hughes MJ. Mortality in Pulmonary Embolism According to Risk Category at Presentation in Emergency Department: Impact of Cardiac Arrest. Am J Cardiol. 2021 Oct 15;157:125-7. doi: 10.1016/j.amjcard.2021.06.029.
• Kudlička J, Mlček M, Hála P, Lacko S, Janák D, Hrachovina M, Malík J, Bělohlávek J, Neužil P, Kittnar O. Pig model of pulmonary embolism: where is the hemodynamic break point? Physiol Res. 2013;62(Suppl 1):S173-9. doi: 10.33549/physiolres.932673.
• Huis In 't Veld MA, Allison MG, Bostick DS, Fisher KR, Goloubeva OG, Witting MD, Winters ME. Ultrasound use during cardiopulmonary resuscitation is associated with delays in chest compressions. Resuscitation. 2017 Oct;119:95-8. doi: 10.1016/j.resuscitation.2017.07.021.
• Long B, Alerhand S, Maliel K, Koyfman A. Echocardiography in cardiac arrest: An emergency medicine review. Am J Emerg Med. 2018 Mar;36(3):488-93. doi: 10.1016/j.ajem.2017.12.031.