[Perioperative pulmonary thromboembolism. A clinical study].

Pulmonary embolism (PE) is a major catastrophe during postoperative period. We had six patients who developed PE after surgery and one during anesthesia and surgery. Severe arterial hypoxemia (PaO2 41 +/- 14 mmHg) occurred in all six postoperative patients, but not in a patient who developed PE under anesthesia. In 3 patients with pulmonary artery catheter in place, pulmonary arterial pressure (PAP) increased significantly during the embolic events. PAP tended to decrease before the apparent improvement of PaO2 in each patient. This suggests that increases in anastomotic bronchial blood flow occurred following the events. In a patient who developed PE under enflurane-N2O-O2 anesthesia, neither hypoxemia nor hypotension occurred despite significant increase in PAP. All patients received heparin and urokinase intravenously, which caused persistent bleeding in two patients. It remains for further investigations to study the mechanisms of serious hypoxemia in postoperative patients with PE as well as those of favorably maintained pulmonary oxygenation in a patient with PE under general anesthesia.