Successful Treatment of Pulmonary Embolism Causing Cardiac Arrests with Reteplase during Neurosurgery: A Case Report

Ehsan Yousefi-Mazhin; Mojtaba Mojtahedzadeh; Hossein  Karballaei-Mirzahosseini; Rezvan Hassanpour; Hamidreza Sharifnia; Farhad Najmeddin; Amirhossein Ameli; Mohammad Javad  Khadem-Abbasi; Mansoureh Fotouhi; Farhad Etezadi; Mohammad Reza Khajavi; Reza Shariat Moharari; Pejman Pourfakhr; Arezoo Ahmadi; Mohammad Reza Neishaboury; Atabak Najafi

doi:10.18502/aacc.v10i4.16271

Ehsan Yousefi-Mazhin Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Mojtaba Mojtahedzadeh Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Hossein Karballaei-Mirzahosseini Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Rezvan Hassanpour Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Hamidreza Sharifnia Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Farhad Najmeddin Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Amirhossein Ameli Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad Javad Khadem-Abbasi Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mansoureh Fotouhi Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Farhad Etezadi Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad Reza Khajavi Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Reza Shariat Moharari Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Pejman Pourfakhr Anesthesia, Critical Care, and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Arezoo Ahmadi Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad Reza Neishaboury Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Atabak Najafi Anesthesia, Critical Care, and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v10i4.16271

Keywords: Reteplase; Cardiac arrest; Pulmonary embolism; Intraoperative

Abstract

Pulmonary embolism can cause cardiac arrest. Fibrinolytic therapy and surgical embolectomy can be used to manage it. This case report presents the clinical course of a patient who experienced intraoperative cardiac arrest resulting from massive pulmonary embolism. The patient encountered three instances of cardiac arrest requiring 35 minutes of cardiopulmonary resuscitation. Subsequent treatment involved the administration of reteplase, a thrombolytic agent. Following resuscitation, the patient developed multiple organ dysfunction in the intensive care unit, necessitating the use of diverse medications. Successful resolution of organ dysfunction led to the patient's transfer to the neurosurgery department. This case highlights the complexities involved in managing pulmonary embolism-induced cardiac arrest and subsequent multiorgan dysfunction, emphasizing the significance of a multidisciplinary approach in the comprehensive care and treatment of these patients.