Introduction: A fulminant pulmonary embolism is a potentially reversible cause of cardiac arrest with a reported mortality rate of up to 95%. Therapeutic strategies for fulminant pulmonary embolism continue to evolve.
Case report: We present a case of a 38-year-old female who suffered an in-hospital cardiac arrest due to fulminant pulmonary embolism. Extracorporeal cardiopulmonary resuscitation (facilitated by the LUCAS™ mechanical chest compression device) was successfully performed in this patient following failure of intraarrest thrombolysis.
Discussion: For the management of fulminant pulmonary embolism, utilization of clot-directed therapies, especially intraarrest thrombolysis, has garnered increasing traction and interest. However, this therapeutic approach has its limitations. Fortuitously, the emergence of extracorporeal cardiopulmonary resuscitation has added a new dimension to the treatment of fulminant pulmonary embolism. A protocolized approach to treatment can improve outcomes in these patients.
Conclusion: Extracorporeal cardiopulmonary resuscitation can be used as a salvage therapy in patients with fulminant pulmonary embolism in whom intraarrest thrombolysis has failed.
Keywords: ECPR; fulminant pulmonary embolism; intraarrest thrombolysis; mechanical CPR.