Wednesday, January 16, 2019

Extracorporeal Membrane Oxygenation for Failed TPA Therapy of Pulmonary Embolism: (ACR) - Lupine Publishers



Pulmonary embolism may cause cardiac arrest secondary to obstruction of blood flow. Traditional treatment strategies include anticoagulation, thrombolysis, and mechanical extraction. Some advocate for support with extra corporeal membrane oxygenation (ECMO); however, surgical therapies are contraindicated following thrombolytics. We describe the emergent use of peripheral ECMO following thrombolytic therapy for a saddle pulmonary embolism associated with multiple episodes of cardiac arrest. The patient was stabilized with peripheral ECMO, anticoagulated and subsequently weaned from ECMO without any major bleeding complications. The administration of thrombolytics should not be a contraindication for ECMO in patients with massive pulmonary embolism associated with hemodynamic instability.


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