Bilateral proximal pulmonary embolism without associated hypoxemia. Case report
Copyright © 2017 Elsevier Masson SAS. All rights reserved..
INTRODUCTION: Pulmonary embolism is a classic complication in intensive care. It is characterized by hypoxemia secondary to perturbed ventilation/perfusion ratios. We report a case of proximal and bilateral pulmonary embolism that occurred without associated hypoxemia. A spiral computed tomography (CT) scan was performed to explore unexplained fever in a patient with a negative infectious investigation. We discuss the mechanisms underlying the absence of hypoxemia in this patient.
CLINICAL CASE: A 43-year-old patient with no significant pathological history was admitted to intensive care for the management of multiple injuries following a road accident. During resuscitation, the patient developed a proximal and bilateral pulmonary embolism without signs of hypertension of the pulmonary artery or associated hypoxemia. The patient improved under treatment.
DISCUSSION: This case shows that bilateral proximal pulmonary embolism may be associated with normal gas exchange. The absence of hypoxemia could be explained by the bilateral nature of the pulmonary embolism that led to balanced ventilation/perfusion ratios on both sides. Furthermore, bronchoconstriction was bilateral, explaining the maintenance of a stable ventilation/perfusion ratio on both sides.
CONCLUSION: The presence of unexplained fever in a victim of multiple trauma, despite the absence of hypoxemia, suggests the diagnosis of pulmonary embolism.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:42 |
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| Enthalten in: |
Journal de medecine vasculaire - 42(2017), 5 vom: 01. Okt., Seite 320-324 |
| Sprache: |
Französisch |
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| Weiterer Titel: |
Embolie pulmonaire proximale bilatérale sans hypoxémie associée. À propos d’un cas |
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| Beteiligte Personen: |
Bahloul, M [VerfasserIn] |
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| Links: |
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| Themen: |
Case Reports |
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| Anmerkungen: |
Date Completed 01.08.2019 Date Revised 01.08.2019 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jdmv.2017.07.004 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM276342119 |
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| 245 | 1 | 0 | |a Bilateral proximal pulmonary embolism without associated hypoxemia. Case report |
| 246 | 3 | 3 | |a Embolie pulmonaire proximale bilatérale sans hypoxémie associée. À propos d’un cas |
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| 500 | |a Date Revised 01.08.2019 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2017 Elsevier Masson SAS. All rights reserved. | ||
| 520 | |a INTRODUCTION: Pulmonary embolism is a classic complication in intensive care. It is characterized by hypoxemia secondary to perturbed ventilation/perfusion ratios. We report a case of proximal and bilateral pulmonary embolism that occurred without associated hypoxemia. A spiral computed tomography (CT) scan was performed to explore unexplained fever in a patient with a negative infectious investigation. We discuss the mechanisms underlying the absence of hypoxemia in this patient | ||
| 520 | |a CLINICAL CASE: A 43-year-old patient with no significant pathological history was admitted to intensive care for the management of multiple injuries following a road accident. During resuscitation, the patient developed a proximal and bilateral pulmonary embolism without signs of hypertension of the pulmonary artery or associated hypoxemia. The patient improved under treatment | ||
| 520 | |a DISCUSSION: This case shows that bilateral proximal pulmonary embolism may be associated with normal gas exchange. The absence of hypoxemia could be explained by the bilateral nature of the pulmonary embolism that led to balanced ventilation/perfusion ratios on both sides. Furthermore, bronchoconstriction was bilateral, explaining the maintenance of a stable ventilation/perfusion ratio on both sides | ||
| 520 | |a CONCLUSION: The presence of unexplained fever in a victim of multiple trauma, despite the absence of hypoxemia, suggests the diagnosis of pulmonary embolism | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Embolie pulmonaire proximale | |
| 650 | 4 | |a Hypoxemia | |
| 650 | 4 | |a Hypoxémie | |
| 650 | 4 | |a Polytrauma | |
| 650 | 4 | |a Polytraumatisme | |
| 650 | 4 | |a Proximal pulmonary embolism | |
| 700 | 1 | |a Chtara, K |e verfasserin |4 aut | |
| 700 | 1 | |a Turki, O |e verfasserin |4 aut | |
| 700 | 1 | |a Kammoun, M M |e verfasserin |4 aut | |
| 700 | 1 | |a Bouaziz, W |e verfasserin |4 aut | |
| 700 | 1 | |a Bouaziz, M |e verfasserin |4 aut | |
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