Pulmonary Embolism Caused by Tourniquets in the Lower Extremities Treated with ECMO – A Case Report

Authors

  • Xiaozu Liao, MD Department of Anesthesiology, Zhongshan City People’s Hospital, Zhongshan, China
  • Miaoyun Guo, MD Department of Anesthesiology, Zhongshan City People’s Hospital, Zhongshan, China
  • Junlin Wen, MD Department of Anesthesiology, Zhongshan City People’s Hospital, Zhongshan, China
  • Weizhao Huang, MD Department of Cardiac Surgery, Zhongshan City People's Hospital, Zhongshan, China
  • Hongyu Ye, MD Department of Cardiac Surgery, Zhongshan City People's Hospital, Zhongshan, China
  • Binfei Li, MD Department of Cardiac Surgery, Zhongshan City People's Hospital, Zhongshan, China

DOI:

https://doi.org/10.1532/hsf.4635

Keywords:

acute pulmonary embolism, ECMO

Abstract

Background: Using tourniquets in the lower extremities can increase the incidence of deep vein thrombosis (DVT). Acute large-area pulmonary embolism (APE) occurs in severe cases, and it is fatal to most patients. Acute large-area pulmonary embolism causes haemodynamic instability, right heart failure, and circulatory failure.

Case presentation: A 47-year-old female patient was subjected to spinal anaesthesia for a comminuted fracture of the tibia and fibula of the left lower limb. After the tourniquet was released during the operation, she had sudden hypotension and lost consciousness. Thus, ECMO was used to support patient circulation. With ECMO-assisted CT examination, she was diagnosed to have a pulmonary embolism. On the next day, she was subjected to a bilateral pulmonary embolism and embolectomy. Lastly, she was transferred to the general ward and discharged smoothly.

Conclusions: Patients undergoing fracture surgery should be wary of APE caused by the loss of DVT after the release of tourniquets. ECMO, as a rapid and effective temporary life support intervention, provides effective cardiopulmonary support and new treatment plans. It also saves time for further treatment of patients with high-risk APE.

References

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Published

2022-06-20

How to Cite

Liao, X., Guo, M., Wen, J., Huang, W., Ye, H., & Li, B. (2022). Pulmonary Embolism Caused by Tourniquets in the Lower Extremities Treated with ECMO – A Case Report. The Heart Surgery Forum, 25(3), E449-E451. https://doi.org/10.1532/hsf.4635

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Section

Articles