Interv Akut Kardiol. 2021;20(3):158-160 | DOI: 10.36290/kar.2021.021

Massive perioperative pulmonary embolism

Tomáš Hnátek¹, Lujza Reková², Tomáš Tyll², Josef Daněk¹, Jan Alt³, Martin Malý¹, Petr Urbánek¹

¹ Interní klinika 1. LF UK a ÚVN, Praha

² Klinika anesteziologie, resuscitace a intenzivní medicíny 1. LF UK a ÚVN, Praha

³ Klinika ortopedie 1. LF UK a ÚVN, Praha

Perioperative massive pulmonary embolism is a potentially fatal complication of surgery under general anesthesia. Clinical signs-appear suddenly appears, very often with unexpected significant circulatory instability - and a rapid development of obstructive shock. Tachycardia, hypotension, decreased EtCO₂ and SpO₂ are typical clinical signs. Diagnostic possibilities in the operating room are limited, we must first rule out the more common causes of shock, especially inadeguate management of massive surgical bleeding. Administration of anticoagulant therapy during surgery is high risk, due to the possible development of uncontrolled bleeding.

Keywords: pulmonary embolism, hypermobile thrombus in the right atrium, bone cement implantation syndrome, anticoagulant therapy.

Received: May 7, 2021; Revised: May 11, 2021; Accepted: May 12, 2021; Prepublished online: May 12, 2021; Published: October 21, 2021  Show citation