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Massive pulmonary embolism occurring during anaesthesia: Report of three cases

  • M. Minuck
Article

Summary

Three cases of massive pulmonary embolus during anaesthesia have been presented. This catastrophe occurred in patients whose preoperative course of bed confinement had set the stage for the possible development of a pulmonary embolus. Two patients developed signs immediately following induction of anaesthesia and one during manipulation of the common iliac vein. An abrupt development of deep cyanosis, unrelieved by ready ventilation of all lung fields with 100 per cent oxygen, in a patient who might be a candidate for pulmonary embolus should evoke the thought of this possibility. The persistence of a palpable peripheral pulse eliminates a primary diagnosis of sudden heart arrest. Steps should be taken to make a swift diagnosis so that definitive treatment may be considered. Finally, these cases emphasize, as Jacoby et al.3 have pointed out, the importance of not accepting responsibility for a death associated with anaesthesia without a thorough post-mortem examination.

Résumé

On présente trois cas d’embolie pulmonaire massive durant l’anesthésie. Cette catastrophe est survenue chez des malades qu’un alitement pré-opératoire prolongé avait prédisposés à cette complication. Deux malades ont présenté des symptômes immédiatement après l’induction et l’autre durant les manipulations de la veine iliaque primitive. L’apparition d’une cyanose importante, non diminuée par la ventilation immédiate à 100 pour cent d’oxygène de toute la surface pulmonaire, chez un malade prédisposé à l’embolie pulmonaire devrait faire penser à cette pathologie. La persistance du pouls périphérique élimine le diagnostic d’arrêt cardiaque. On doit s’appliquer à faire un diagnostic rapide et précis afin d’étudier la possibilité d’un traitement adéquat. Enfin ces cas soulignent comme l’ont fait remarquer Jacoby et collaborateurs, l’importance de pratiquer une autopsie complète avant d’accepter la responsabilité d’une mort imputable à l’anesthésie.

Keywords

Thiopentone Cent Oxygen Massive Pulmonary Embolism Gallamine Methoxamine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Browne, R. A. &Catton, D. V. Massive Pulmonary Embolism during Anaesthesia: A Report of Two Cases. Canad. Anaesth. Soc. J.14: 413 (1967).PubMedCrossRefGoogle Scholar
  2. 2.
    Natof, H. E. &Sadove, M. S. Cardiovascular Collapse in the Operating Room. Lippincott (1958).Google Scholar
  3. 3.
    Jacoby, J.;Lutsky, I. I.;Henschel, E. O.; &Green, R. E. Fatalities Erroneously Attributed to Anesthesia. Anesth. & Analg.44: 53 (1965).Google Scholar

Copyright information

© Canadian Anesthesiologists 1968

Authors and Affiliations

  • M. Minuck
    • 1
    • 2
  1. 1.Department of AnaesthesiaSt. Boniface General HospitalSt. Boniface
  2. 2.Department of AnaesthesiaUniversity of ManitobaUSA

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