Severe refractory hypoxaemia in submassive pulmonary embolism: a surrogate marker of severe right ventricular dysfunction and indication for thrombolysis
Version of Record online: 14 JUN 2012
© 2012 The Authors. Internal Medicine Journal © 2012 Royal Australasian College of Physicians
Internal Medicine Journal
Volume 42, Issue 6, pages 712–715, June 2012
How to Cite
Braude, S. and Martens-Nielsen, J. (2012), Severe refractory hypoxaemia in submassive pulmonary embolism: a surrogate marker of severe right ventricular dysfunction and indication for thrombolysis. Internal Medicine Journal, 42: 712–715. doi: 10.1111/j.1445-5994.2012.02813.x
Conflict of interest: None.
- Issue online: 14 JUN 2012
- Version of Record online: 14 JUN 2012
- Received 17 February 2011; accepted 22 June 2011.
- hypoxaemia in pulmonary embolism;
- thrombolysis in pulmonary embolism.
The role of thrombolysis in pulmonary thromboembolism is controversial. We describe a case of life-threatening acute pulmonary embolism where thrombolysis was successfully administered because of extreme refractory hypoxaemia. We suggest that profound refractory hypoxaemia in this clinical setting was due to the combination of severe right ventricular dysfunction and shunting from pulmonary infarction. The shunt was not likely to have resolved in the short term, but right ventricular function and hypoxaemia improved with clot lysis. Similar clinical presentations should prompt active consideration of thrombolysis.