Korean J Crit Care Med.  2008 Dec;23(2):111-114. 10.4266/kjccm.2008.23.2.111.

Management of Pulmonary Thromboembolism with Inferior Vena Cava Filter: A Case Report

Affiliations
  • 1Department of Anesthesiology, The Catholic University College of Medicine, Seoul, Korea. genovia@catholic.ac.kr
  • 2Department of Radiology, The Catholic University College of Medicine, Seoul, Korea.

Abstract

We managed a case in which an inferior vena cava filter was inserted for a pulmonary thromboembolism that occurred during general anesthesia. A 71-year-old woman was prepped for reduction of a distal femur fracture and arthroplastic surgery. Her initial vital signs were stable, but the end-tidal CO2 and SaO2 were decreased gradually after application of the tourniquet for surgery. Because of impaired ventricular wall motion and a dilated inferior vena cava on echocardiogram, we suspected a pulmonary thromboembolism. Thus, we inserted an inferior vena cava filter percutaneously under propofol sedation in the Radiology Department. In addition to ventilatory support and hemodynamic management, heparin was administered as anticoagulant therapy postoperatively in the intensive care unit. Multiple thrombi in the pulmonary artery were confirmed on chest CT. On the 4th postoperative day, she was transferred to the general ward without any complications.

Keyword

perioerative; pulmonary thromboembolism; inferior vena cava filte
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