Kelsei P Keene, Pete P Fong, John M Trahanas, Bantayehu Sileshi
{"title":"Acute Intraoperative Pulmonary Embolism Management in the Era of Pulmonary Embolism Response Teams and Minimally Invasive Therapy: A Case Report.","authors":"Kelsei P Keene, Pete P Fong, John M Trahanas, Bantayehu Sileshi","doi":"10.1177/10892532251356125","DOIUrl":null,"url":null,"abstract":"<p><p>Intraoperative acute pulmonary embolism (PE) is a rare and life-threatening event with symptoms such as pleuritic chest pain, shortness of breath, and anxiety, which are easily masked by general anesthesia. To diagnose PE in a patient under general anesthesia, anesthesiologists must rely on alternative data points such as hypoxia, decreased end-tidal carbon dioxide (ETCO2), tachycardia, electrocardiogram changes, and intraoperative echocardiography. We present a case of acute intraoperative massive PE in a patient undergoing posterior spinal fusion. We discuss the management of acute perioperative PE, focusing on surgical risk, bleeding potential with thrombolytic therapies and anticoagulation, recent advances in catheter-based therapies, and the role of Pulmonary Embolism Response Teams (PERTs) in the assessment and perioperative management of high-risk patients.</p>","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":" ","pages":"10892532251356125"},"PeriodicalIF":1.1000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in Cardiothoracic and Vascular Anesthesia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/10892532251356125","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Intraoperative acute pulmonary embolism (PE) is a rare and life-threatening event with symptoms such as pleuritic chest pain, shortness of breath, and anxiety, which are easily masked by general anesthesia. To diagnose PE in a patient under general anesthesia, anesthesiologists must rely on alternative data points such as hypoxia, decreased end-tidal carbon dioxide (ETCO2), tachycardia, electrocardiogram changes, and intraoperative echocardiography. We present a case of acute intraoperative massive PE in a patient undergoing posterior spinal fusion. We discuss the management of acute perioperative PE, focusing on surgical risk, bleeding potential with thrombolytic therapies and anticoagulation, recent advances in catheter-based therapies, and the role of Pulmonary Embolism Response Teams (PERTs) in the assessment and perioperative management of high-risk patients.