Postoperative pulmonary embolism in a three year old with Klippel–Trenaunay syndrome

Jana Hudcova1, Monica Kleinman2, Daniel Talmor11Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; 2Department of Anesthesia, Division of Critical Care Medicine, Children’s Hospital Boston and Har...

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Main Authors: Jana Hudcova, Monica Kleinman, Daniel Talmor
Format: Article
Language:English
Published: Dove Medical Press 2009-01-01
Series:International Medical Case Reports Journal
Online Access:http://www.dovepress.com/postoperative-pulmonary-embolism-in-a-three-year-old-with-klippelndash-a2830
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author Jana Hudcova
Monica Kleinman
Daniel Talmor
author_facet Jana Hudcova
Monica Kleinman
Daniel Talmor
author_sort Jana Hudcova
collection DOAJ
description Jana Hudcova1, Monica Kleinman2, Daniel Talmor11Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; 2Department of Anesthesia, Division of Critical Care Medicine, Children’s Hospital Boston and Harvard Medical School, Boston, MA, USAAbstract: Massive pulmonary embolism (PE) in a small child is a rare event and unified guidelines for its treatment are missing. Timely diagnosis and management of massive pulmonary embolism is of crucial importance for a good outcome. We describe a unique management of PE causing oxygenation failure using a combination of catheter extraction technique, and regional thrombolysis on top of systemic heparin administration and inferior vena cava filter placement. Pulmonary hypertension was treated with inhaled nitric oxide. We believe that catheter extraction technique and regional thrombolysis is an option to consider provided that resources and expertise are available. Preoperative placement of an inferior vena cava filter should be contemplated in such high risk situations.Keywords: embolectomy, regional thrombolysis, inferior vena cava filter, inhaled nitric oxide
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spelling doaj.art-285a7aab3abe476f9088618e8a3275882022-12-21T19:41:45ZengDove Medical PressInternational Medical Case Reports Journal1179-142X2009-01-012009default15Postoperative pulmonary embolism in a three year old with Klippel–Trenaunay syndromeJana HudcovaMonica KleinmanDaniel TalmorJana Hudcova1, Monica Kleinman2, Daniel Talmor11Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; 2Department of Anesthesia, Division of Critical Care Medicine, Children’s Hospital Boston and Harvard Medical School, Boston, MA, USAAbstract: Massive pulmonary embolism (PE) in a small child is a rare event and unified guidelines for its treatment are missing. Timely diagnosis and management of massive pulmonary embolism is of crucial importance for a good outcome. We describe a unique management of PE causing oxygenation failure using a combination of catheter extraction technique, and regional thrombolysis on top of systemic heparin administration and inferior vena cava filter placement. Pulmonary hypertension was treated with inhaled nitric oxide. We believe that catheter extraction technique and regional thrombolysis is an option to consider provided that resources and expertise are available. Preoperative placement of an inferior vena cava filter should be contemplated in such high risk situations.Keywords: embolectomy, regional thrombolysis, inferior vena cava filter, inhaled nitric oxidehttp://www.dovepress.com/postoperative-pulmonary-embolism-in-a-three-year-old-with-klippelndash-a2830
spellingShingle Jana Hudcova
Monica Kleinman
Daniel Talmor
Postoperative pulmonary embolism in a three year old with Klippel–Trenaunay syndrome
International Medical Case Reports Journal
title Postoperative pulmonary embolism in a three year old with Klippel–Trenaunay syndrome
title_full Postoperative pulmonary embolism in a three year old with Klippel–Trenaunay syndrome
title_fullStr Postoperative pulmonary embolism in a three year old with Klippel–Trenaunay syndrome
title_full_unstemmed Postoperative pulmonary embolism in a three year old with Klippel–Trenaunay syndrome
title_short Postoperative pulmonary embolism in a three year old with Klippel–Trenaunay syndrome
title_sort postoperative pulmonary embolism in a three year old with klippel amp ndash trenaunay syndrome
url http://www.dovepress.com/postoperative-pulmonary-embolism-in-a-three-year-old-with-klippelndash-a2830
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AT monicakleinman postoperativepulmonaryembolisminathreeyearoldwithklippelampndashtrenaunaysyndrome
AT danieltalmor postoperativepulmonaryembolisminathreeyearoldwithklippelampndashtrenaunaysyndrome