Ruptured subcapsular liver haematoma following mechanically-assisted cardiopulmonary resuscitation
A 64-year-old man with a history of ascending aortic surgery and pulmonary embolus presented with shortness of breath. He rapidly decompensated, prompting intubation, after which he lost pulses. Manual resuscitation was initiated immediately, with subsequent use of a LUCAS-2 mechanical compression d...
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| Veröffentlicht in: | BMJ case reports 2016-02, Vol.2016, p.bcr2015213951 |
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| description | A 64-year-old man with a history of ascending aortic surgery and pulmonary embolus presented with shortness of breath. He rapidly decompensated, prompting intubation, after which he lost pulses. Manual resuscitation was initiated immediately, with subsequent use of a LUCAS-2 mechanical compression device. The patient was given bolus thrombolytic therapy and regained pulses after 7 min of CPR. Compressions were reinitiated with the LUCAS-2 twice more during resuscitation over the subsequent hour for brief episodes of PEA. After confirmation of massive pulmonary embolism on CT, the patient underwent interventional radiology-guided ultrasonic catheter placement with local thrombolytic therapy and experienced immediate improvement in oxygenation. He later developed abdominal compartment syndrome, despite cessation of thrombolytic and anticoagulation therapy. Bedside exploratory abdominal laparotomy revealed a ruptured subcapsular haematoma of the liver. The patient's haemodynamics improved following surgery and he was extubated 11 days postarrest with intact neurological function. |
| doi_str_mv | 10.1136/bcr-2015-213951 |
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He rapidly decompensated, prompting intubation, after which he lost pulses. Manual resuscitation was initiated immediately, with subsequent use of a LUCAS-2 mechanical compression device. The patient was given bolus thrombolytic therapy and regained pulses after 7 min of CPR. Compressions were reinitiated with the LUCAS-2 twice more during resuscitation over the subsequent hour for brief episodes of PEA. After confirmation of massive pulmonary embolism on CT, the patient underwent interventional radiology-guided ultrasonic catheter placement with local thrombolytic therapy and experienced immediate improvement in oxygenation. He later developed abdominal compartment syndrome, despite cessation of thrombolytic and anticoagulation therapy. Bedside exploratory abdominal laparotomy revealed a ruptured subcapsular haematoma of the liver. The patient's haemodynamics improved following surgery and he was extubated 11 days postarrest with intact neurological function.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2015-213951</identifier><identifier>PMID: 26838302</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Abdomen ; Advantages ; Cardiopulmonary resuscitation ; Cardiopulmonary Resuscitation - adverse effects ; Cardiopulmonary Resuscitation - instrumentation ; Cardiopulmonary Resuscitation - methods ; CPR ; Embolisms ; Emergency medical care ; Emergency Service, Hospital ; Heart failure ; Hematoma - etiology ; Humans ; Injuries ; Liver ; Liver Diseases - etiology ; Male ; Middle Aged ; Pulmonary Embolism - therapy ; Rupture ; Ultrasonic imaging ; Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions ; USA/Canada ; White</subject><ispartof>BMJ case reports, 2016-02, Vol.2016, p.bcr2015213951</ispartof><rights>2016 BMJ Publishing Group Ltd</rights><rights>2016 BMJ Publishing Group Ltd.</rights><rights>Copyright: 2016 2016 BMJ Publishing Group Ltd</rights><rights>2016 BMJ Publishing Group Ltd 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b3711-d718a7c87f3da001213c048c8e9ad870162bd98868a5badacd6ff080dd3af9363</citedby><cites>FETCH-LOGICAL-b3711-d718a7c87f3da001213c048c8e9ad870162bd98868a5badacd6ff080dd3af9363</cites><orcidid>0000-0002-0343-9823</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4746549/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4746549/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26838302$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Joseph, John R</creatorcontrib><creatorcontrib>Freundlich, Robert Edward</creatorcontrib><creatorcontrib>Abir, Mahshid</creatorcontrib><title>Ruptured subcapsular liver haematoma following mechanically-assisted cardiopulmonary resuscitation</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><description>A 64-year-old man with a history of ascending aortic surgery and pulmonary embolus presented with shortness of breath. He rapidly decompensated, prompting intubation, after which he lost pulses. Manual resuscitation was initiated immediately, with subsequent use of a LUCAS-2 mechanical compression device. The patient was given bolus thrombolytic therapy and regained pulses after 7 min of CPR. Compressions were reinitiated with the LUCAS-2 twice more during resuscitation over the subsequent hour for brief episodes of PEA. After confirmation of massive pulmonary embolism on CT, the patient underwent interventional radiology-guided ultrasonic catheter placement with local thrombolytic therapy and experienced immediate improvement in oxygenation. He later developed abdominal compartment syndrome, despite cessation of thrombolytic and anticoagulation therapy. Bedside exploratory abdominal laparotomy revealed a ruptured subcapsular haematoma of the liver. The patient's haemodynamics improved following surgery and he was extubated 11 days postarrest with intact neurological function.</description><subject>Abdomen</subject><subject>Advantages</subject><subject>Cardiopulmonary resuscitation</subject><subject>Cardiopulmonary Resuscitation - adverse effects</subject><subject>Cardiopulmonary Resuscitation - instrumentation</subject><subject>Cardiopulmonary Resuscitation - methods</subject><subject>CPR</subject><subject>Embolisms</subject><subject>Emergency medical care</subject><subject>Emergency Service, Hospital</subject><subject>Heart failure</subject><subject>Hematoma - etiology</subject><subject>Humans</subject><subject>Injuries</subject><subject>Liver</subject><subject>Liver Diseases - etiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pulmonary Embolism - therapy</subject><subject>Rupture</subject><subject>Ultrasonic imaging</subject><subject>Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions</subject><subject>USA/Canada</subject><subject>White</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkc1LxDAUxIMoKurZmxS8iFBNmrZJL4KIXyAIouAtvCapmyVtatKs-N-bZVXUi7kk8H5vmMkgtE_wCSG0Pm2lzwtMqrwgtKnIGtomrGI5a_Dz-o_3FtoLYY7ToaTkJd1EW0XNKae42EbtQxyn6LXKQmwljCFa8Jk1C-2zGegeJtdD1jlr3ZsZXrJeyxkMRoK17zmEYMKUdiV4ZdwYbe8G8O-Z1yEGaSaYjBt20UYHNui9z3sHPV1dPl7c5Hf317cX53d5SxkhuWKEA5OcdVQBxiSFkrjkkusGFGeY1EWrGs5rDlULCqSquw5zrBSFrqE13UFnK90xtr1WUg-TBytGb_rkSTgw4vdkMDPx4haiZGVdlU0SOPoU8O416jCJ3gSprYVBuxgEYXX6OJK8JfTwDzp30Q8pXqI4pbhq8NLR6YqS3oXgdfdthmCxrFCkCsWyQrGqMG0c_MzwzX8VloDjFdD283_VPgBPr6fG</recordid><startdate>20160202</startdate><enddate>20160202</enddate><creator>Joseph, John R</creator><creator>Freundlich, Robert Edward</creator><creator>Abir, Mahshid</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0343-9823</orcidid></search><sort><creationdate>20160202</creationdate><title>Ruptured subcapsular liver haematoma following mechanically-assisted cardiopulmonary resuscitation</title><author>Joseph, John R ; Freundlich, Robert Edward ; Abir, Mahshid</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b3711-d718a7c87f3da001213c048c8e9ad870162bd98868a5badacd6ff080dd3af9363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Abdomen</topic><topic>Advantages</topic><topic>Cardiopulmonary resuscitation</topic><topic>Cardiopulmonary Resuscitation - adverse effects</topic><topic>Cardiopulmonary Resuscitation - instrumentation</topic><topic>Cardiopulmonary Resuscitation - methods</topic><topic>CPR</topic><topic>Embolisms</topic><topic>Emergency medical care</topic><topic>Emergency Service, Hospital</topic><topic>Heart failure</topic><topic>Hematoma - etiology</topic><topic>Humans</topic><topic>Injuries</topic><topic>Liver</topic><topic>Liver Diseases - etiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pulmonary Embolism - therapy</topic><topic>Rupture</topic><topic>Ultrasonic imaging</topic><topic>Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions</topic><topic>USA/Canada</topic><topic>White</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Joseph, John R</creatorcontrib><creatorcontrib>Freundlich, Robert Edward</creatorcontrib><creatorcontrib>Abir, Mahshid</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ case reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Joseph, John R</au><au>Freundlich, Robert Edward</au><au>Abir, Mahshid</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ruptured subcapsular liver haematoma following mechanically-assisted cardiopulmonary resuscitation</atitle><jtitle>BMJ case reports</jtitle><addtitle>BMJ Case Rep</addtitle><date>2016-02-02</date><risdate>2016</risdate><volume>2016</volume><spage>bcr2015213951</spage><pages>bcr2015213951-</pages><issn>1757-790X</issn><eissn>1757-790X</eissn><abstract>A 64-year-old man with a history of ascending aortic surgery and pulmonary embolus presented with shortness of breath. He rapidly decompensated, prompting intubation, after which he lost pulses. Manual resuscitation was initiated immediately, with subsequent use of a LUCAS-2 mechanical compression device. The patient was given bolus thrombolytic therapy and regained pulses after 7 min of CPR. Compressions were reinitiated with the LUCAS-2 twice more during resuscitation over the subsequent hour for brief episodes of PEA. After confirmation of massive pulmonary embolism on CT, the patient underwent interventional radiology-guided ultrasonic catheter placement with local thrombolytic therapy and experienced immediate improvement in oxygenation. He later developed abdominal compartment syndrome, despite cessation of thrombolytic and anticoagulation therapy. Bedside exploratory abdominal laparotomy revealed a ruptured subcapsular haematoma of the liver. 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| subjects | Abdomen Advantages Cardiopulmonary resuscitation Cardiopulmonary Resuscitation - adverse effects Cardiopulmonary Resuscitation - instrumentation Cardiopulmonary Resuscitation - methods CPR Embolisms Emergency medical care Emergency Service, Hospital Heart failure Hematoma - etiology Humans Injuries Liver Liver Diseases - etiology Male Middle Aged Pulmonary Embolism - therapy Rupture Ultrasonic imaging Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions USA/Canada White |
| title | Ruptured subcapsular liver haematoma following mechanically-assisted cardiopulmonary resuscitation |
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