Intraoperative cardiopulmonary collapse despite prophylactic anticoagulation for thromboembolism

Ju Deok Kim, C. Cheng, D. Shim, Doosik Kim, S. Ryu, Yusom Shin
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Abstract

Prophylactic anticoagulation for high-risk patients of pulmonary embolism (PE) prevails as acute PE potentially leads to hemodynamic instability resulting in death. Notwithstanding the adequate thromboprophylaxis, rarely, we may face a patient ’ s critical condition with PE. We report here on the patient given intraoperative cardiopulmonary resuscitation that the cause was revealed to be PE despite subcutaneous anticoagulant until the day before scheduled secondary operation. The 72-year-old male patient had already undergone first emergency surgery for right tibia and patella fractures without any problems. Albeit effective, prophylaxis for thromboembolism cannot guarantee PE prevention. With this sobering fact in mind, addi-tionally, early diagnosis and prompt management of PE, especially through interdepartmental coordination, should produce patients ’ best outcomes.
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尽管预防性抗凝治疗血栓栓塞,术中仍发生心肺衰竭
肺栓塞高危患者普遍采用预防性抗凝治疗,因为急性肺栓塞可能导致血流动力学不稳定而导致死亡。尽管有充分的血栓预防,但我们很少会遇到PE患者的危重情况。我们在此报告一位接受术中心肺复苏的患者,尽管皮下使用抗凝剂,但直到预定的二次手术前一天才发现病因为PE。这名72岁的男性患者已经因右胫骨和髌骨骨折接受了第一次紧急手术,没有任何问题。预防血栓栓塞虽然有效,但不能保证PE的预防。考虑到这一清醒的事实,此外,早期诊断和及时管理PE,特别是通过部门间协调,应该产生患者最好的结果。
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