Pulmonary Embolism and PEA Arrest Requiring VA ECMO following Roux-en-Y Gastric Bypass

 

Pulmonary embolism is a potentially devastating post-operative complication. Because of this, incredible care is taken at all institutions to prevent perioperative venous thrombo-embolism with the use of models to stratify risk and protocols for prevention. However, even then, pulmonary embolism must remain on the differential if the patient does have acute perioperative cardiovascular or pulmonary derangements. As the anesthesiologist is often the first person to initiate treatment, it is important to understand hemodynamic goals when giving supportive care. It is equally important to know who to consult to determine further management. Many hospitals now have multidisciplinary teams known as Pulmonary Embolism Response teams that will aid in determining further therapies, which is especially helpful given the multitude of treatment modalities and expanding use of invasive procedures including embolectomies and mechanical circulatory support.