Dr. BR. Bageerathi, Dr.V.S. Senthil Kumar, Dr.R. Purushotham


Preoperative pulmonary emboli in traumatic patients are common. The incidence of thromboemboli events in trauma patients is about 63%. Timely diagnosis and treatment can improve patient’s survival. Pulmonary embolism can be difficult to detect prior to hemodynamic instability. Massive pulmonary embolism manifest as physiologic instability,hypoxemia,unresponsive to conventional therapy,cardiac arrest. Treatment includes emergent pulmonary embolectomy,thrombolysis ,extra corporal  membrane oxygenation  (ECMO). Here I present a case report of intra operative pulmonary embolism and the anaesthetic goal is to evaluate the available modality for early detection and supportive care after hemodynamic collapse.


Pulmonary Embolism, Extracorporeal Membrane Oxygenation, Total Hip Replacement.

Full Text:



Toker S., Hak D., Morgan S. Deep vein thrombosis prophylaxis in trauma patients. Thrombosis. 2011;2011:11. doi: 10.1155/2011/505373.505373

Visnjevac O., Pourafkari L., Nader N. D. Role of perioperative monitoring in diagnosis of massive intraoperative cardiopulmonary embolism. Journal Of Cardiovascular and Thoracic Research. 2014;6(3):141–145. doi: 10.15171/jcvtr.2014.002.

Smeltz A. M., Kolarczyk L. M., Isaak R. S. Update on perioperative pulmonary embolism management: A decision support tool to aid in diagnosis and treatment. Advances in Anesthesia. 2017;35(1):213–228. doi: 10.1016/j.aan.2017.08.001.

L. Sermeus, J. Van Hemelrijck, J. Vandommele, and H. Van Aken, “Pulmonary embolism confirmed by transoesophageal echocardiography,” Anaesthesia, vol. 47, no. 1, pp. 28-29, 1992.

R. Chang, J. C. Cardenas, C. E. Wade, and J. B. Holcomb, “Advances in the understanding of trauma-induced coagulopathy,” Blood, vol. 128, no. 8, pp. 1043–1049, 2016.

R. Chang, J. C. Cardenas, C. E. Wade, and J. B. Holcomb, “Advances in the understanding of trauma-induced coagulopathy,” in Blood, blood-2016-01-636423, 2016.

R. Parakh, V. V. Kakkar, and A. K. Kakkar, “Management of venous thromboembolism,” The Journal of the Association of Physicians of India, vol. 55, pp. 49–70, 2007.

S. Garvin, O. Stundner, and S. G. Memtsoudis, “Transesophageal echocardiography during cardiac arrest in orthopedic surgery patients: A report of two cases and a review of the literature,” HSS Journal ®, vol. 9, no. 3, pp. 275–277, 2013.

E. V. Dolmatova, K. Moazzami, T. P. Cocke et al., “Extracorporeal membrane oxygenation in massive pulmonary embolism,” Heart & Lung: The Journal of Acute and Critical Care, vol. 46, no. 2, pp. 106–109, 2017.

F. Corsi, G. Lebreton, N. Bréchot et al., “Life-threatening massive pulmonary embolism rescued by venoarterial-extracorporeal membrane oxygenation,” Critical Care, vol. 21, no. 1, p. 76, 2017.

O. E. Dahl, T. E. Gudmundsen, B. T. Bjørnarå, and D. M. Solheim, “Risk of clinical pulmonary embolism after joint surgery in patients receiving low-molecular-weight heparin prophylaxis in hospital: A 10-year prospective register of 3,954 patients,” Acta Orthopaedica, vol. 74, no. 3, pp. 299–304, 2003.

A. Gonzalez Della Valle, A. Blanes Perez, Y.-Y. Lee et al., “The clinical severity of patients diagnosed with an in-hospital pulmonary embolism following modern, elective joint arthroplasty is unrelated to the location of emboli in the pulmonary vasculature,” The Journal of Arthroplasty, vol. 32, no. 4, pp. 1304–1309, 2017.

L. A. Poultsides, A. Gonzalez Della Valle, S. G. Memtsoudis et al., “Meta-analysis of cause of death following total joint replacement using different thromboprophylaxis regimens,” The Journal of Bone & Joint Surgery (British Volume), vol. 94, no. 1, pp. 113–121, 2012.


  • There are currently no refbacks.