A patient surviving cardiac arrest caused by acute massive pulmonary embolisms during cesarean section with complications of severe respiratory tract and abdominal hemorrhage, and heparin-induced thrombocytopenia

DOI
  • Shimonihara Naoko
    Department of Critical Care and Emergency Medicine, Otsu Municipal Hospital
  • Kooguchi Kunihiko
    Department of Critical Care and Emergency Medicine, Otsu Municipal Hospital
  • Fukui Michihiko
    Department of Critical Care and Emergency Medicine, Otsu Municipal Hospital
  • Fujiwara Daisuke
    Department of Critical Care and Emergency Medicine, Otsu Municipal Hospital
  • Kato Yukinori
    Department of Critical Care and Emergency Medicine, Otsu Municipal Hospital
  • Watanabe Hiroki
    Department of Critical Care and Emergency Medicine, Otsu Municipal Hospital
  • Hamasaki Mikihisa
    Department of Critical Care and Emergency Medicine, Otsu Municipal Hospital
  • Kimata Masaki
    Department of Cardiovascular Internal Medicine, Otsu Municipal Hospital

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Other Title
  • 帝王切開術中巨大肺塞栓症により心停止し大量気道・腹腔内出血，へパリン起因性血小板減少症を合併したが後遺症なく社会復帰した1症例

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Abstract

Deep venous thromboses are more likely to develop during pregnancy. A 39-year-old woman developed acute massive pulmonary embolisms and cardiac arrest during cesarean section. She was resuscitated with percutaneous cardiopulmonary support (PCPS). Heparin was continuously administered for anticoagulation. Thromboses in the pulmonary arteries were fragmented using a balloon catheter. She developed severe hemorrhage from the respiratory tract and abdominal cavity, and the hemorrhage was controlled by keeping the activating clotting time low. In addition to these complications, heparin-induced thrombocytopenia (HIT) occurred after withdrawal of PCPS and was treated with argatroban. She subsequently recovered without any complications and achieved full rehabilitation.

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