Zhang Qishuo, Ou Xiaomin, Liu Wanshan, Xiao Lifeng
Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Emergency Department, Shantou Central Hospital, Shantou, Guangdong, China.
Int J Surg Case Rep. 2025 Jul;132:111434. doi: 10.1016/j.ijscr.2025.111434. Epub 2025 May 13.
Acute pulmonary embolism, as one of the most common and dangerous diseases, sometimes can develop into cardiac arrest before receiving Computed Tomography Angiography (CTA) or other confirmatory workup. The success rate with merely Cardiopulmonary resuscitation (CPR) is extremely low, which raises the question whether it is appropriate to make medical decisions and treat patients empirically with systemic thrombolytic therapy based on point-of-care ultrasound.
This case series reported three cases in which patients presented with cardiac arrest in the emergency department, given the cases were too emergent for CTA, pulmonary embolism was diagnosed based on point-of-care ultrasound given the emergency of the condition, the patient was given systemic thrombolytic therapy with continuous CPR, and achieved Return of Spontaneous Circulation (ROSC).
These cases discuss the importance of bedside ultrasound in the rapid identification of acute pulmonary embolism and the importance of intravenous thrombolysis in the context of continuous cardiopulmonary resuscitation.
Point of care ultrasound plays a crucial role in rapidly identifying acute pulmonary embolism in the emergency department. Systematic therapy with continuous CPR is an effective management for patients with cardiac arrest secondary to acute pulmonary embolism.
急性肺栓塞作为最常见且危险的疾病之一，有时在接受计算机断层扫描血管造影（CTA）或其他确诊检查之前就可能发展为心脏骤停。仅进行心肺复苏（CPR）的成功率极低，这就引发了一个问题，即基于床旁超声进行经验性的医疗决策并对患者进行全身溶栓治疗是否合适。
本病例系列报告了3例患者在急诊科出现心脏骤停的情况，鉴于病情紧急无法进行CTA检查，基于床旁超声诊断为肺栓塞，鉴于病情紧急，在持续进行CPR的同时给予患者全身溶栓治疗，并实现了自主循环恢复（ROSC）。
这些病例讨论了床旁超声在快速识别急性肺栓塞中的重要性以及在持续心肺复苏情况下静脉溶栓的重要性。
床旁超声在急诊科快速识别急性肺栓塞中起着关键作用。持续进行CPR的系统治疗是急性肺栓塞继发心脏骤停患者的有效管理方法。
