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

Year 2023, Volume: 5 Issue: 1, 48 - 50, 29.01.2023
https://doi.org/10.46310/tjim.1069084

Abstract

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.

References

  • 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.
Year 2023, Volume: 5 Issue: 1, 48 - 50, 29.01.2023
https://doi.org/10.46310/tjim.1069084

Abstract

References

  • 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.
There are 6 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Case Reports
Authors

Agit Akgül 0000-0002-7706-0963

Publication Date January 29, 2023
Submission Date February 7, 2022
Acceptance Date November 18, 2022
Published in Issue Year 2023 Volume: 5 Issue: 1

Cite

EndNote Akgül A (January 1, 2023) The use of ultrasonography to guide diagnosis and treatment in resuscitation in a case of arrest due to pulmonary embolism. Turkish Journal of Internal Medicine 5 1 48–50.

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