Complete Cognitive Recovery and Survival From Massive Pulmonary Embolism During General Anesthesia after Administration of Alteplase: A Case Report

Abstract

Presented herein is the case of a 37-year-old male who was scheduled for an anterior decompressive laminectomy after suffering trauma to the cervical area (C6–C7). An intraoperative acute pulmonary embolism (APE) was suspected after persistent hypoxemia and a decreased end-tidal CO2 that was refractory to proper management. After 6 intraoperative episodes of cardiac arrest that followed, intravenous alteplase (thrombolytic therapy) was administered, and the patient was stabilized without major complications. Eventually, APE was successfully diagnosed and treated. The experience served as reference for the diagnosis and management of APE under general anesthesia.