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Massive pulmonary thromboembolism during arthroscopic surgery: the important roles of chest compression and endotracheal intubation

A case of acute massive pulmonary embolism event happened during fracture fixation in our department recently. Shortly after surgery has begun, vital signs of the patient fluctuated emergently, his consciousness was lost, blood pressure and heart rate was once lost in monitor. We immediately started cardiopulmonary resuscitation plans, including setting up advanced life support, chest compressions and cryogenic brain protection strategy, opening center vein to establish a blood pressure, and monitoring central venous pressure and arterial blood pressure. When trying to maintain the vital signs stable, we improved the relevant inspection at the same time. Through a multidisciplinary collaborative diagnosis, acute massive pulmonary embolism was diagnosed. Heparin was given for anticoagulation, and recombinant tissue plasminogen activator was used for thrombolysis treatment. After vital signs were stable, the patient was transferred to the intensive care unit. Then, the disease progressed into multiple organs failure. After treatment for nearly a month, the patient was discharged, without any sequela or complications.

Author(s): Guoqiang Chen, Qin Xia, Liwei Liu, Cheng Li, Shukun Fu