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{
    "pk": 61799,
    "title": "A Positive Outcome Post Alteplase, ECMO and Emergent Surgery in a  Case of Massive Pulmonary Embolism Cardiac Arrest Complicated by  Intra-Abdominal Bleeding",
    "subtitle": null,
    "abstract": "Acute pulmonary embolism is stratified into three groups: low-risk, moderate-risk, and high-risk. Highrisk PE, also known as massive pulmonary embolism (MPE), is defined as an acute PE with sustained  hypotension, pulselessness, and persistent bradycardia. Herein, we present a case of a 44-year-old female  presenting to the emergency department with shortness of breath, chest discomfort, and central cyanosis.  She was found to have MPE and arrested twice during which she received alteplase and Advanced Cardiac  Life Support. In the ICU, she arrested for the third time, was resuscitated, and a decision to initiate  extracorporeal membrane oxygenation deemed reasonable. The patient deteriorated and was rushed to  the operating room after detecting major intra-abdominal bleeding on FAST exam. Hepatic injury was  suspected and liver packing was initiated. Patient was safely discharged home neurologically intact after  a prolonged hospital stay.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Bleeding"
        },
        {
            "word": "ECMO"
        },
        {
            "word": "Massive Pulmonary Embolism"
        },
        {
            "word": "resuscitation"
        },
        {
            "word": "Thrombolytic therapy"
        }
    ],
    "section": "Case Report",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/5rv0m565",
    "frozenauthors": [
        {
            "first_name": "Faysal",
            "middle_name": "",
            "last_name": "Tabbara",
            "name_suffix": "",
            "institution": "American University of Beirut Medical Center",
            "department": ""
        },
        {
            "first_name": "Rola",
            "middle_name": "",
            "last_name": "Cheaito",
            "name_suffix": "",
            "institution": "American University of Beirut Medical Center",
            "department": ""
        },
        {
            "first_name": "Mohamad Ali",
            "middle_name": "",
            "last_name": "Cheaito",
            "name_suffix": "",
            "institution": "American University of Beirut Medical Center",
            "department": ""
        },
        {
            "first_name": "Aline",
            "middle_name": "",
            "last_name": "El Zakhem",
            "name_suffix": "",
            "institution": "American University of Beirut Medical Center",
            "department": ""
        },
        {
            "first_name": "Imad",
            "middle_name": "",
            "last_name": "El Majzoub",
            "name_suffix": "",
            "institution": "American University of Beirut Medical Center",
            "department": ""
        }
    ],
    "date_submitted": "2021-01-08T03:46:39-05:00",
    "date_accepted": "2021-01-08T03:46:39-05:00",
    "date_published": "2022-07-08T03:00:00-04:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/uciem_medjem/article/61799/galley/47678/download/"
        }
    ]
}