Pulmonary Embolism During Hepatoblastoma Resection [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-45336 | DOI: 10.5152/TJAR.2019.45336  

Pulmonary Embolism During Hepatoblastoma Resection

Alkin Çolak1, Ümit Nusret Başaran2, Elif Çopuroğlu1, Fatih Sağ1, Zafer Çakıcı1, Güven Kıray1
1Department of Anaesthesiology and Reanimation, Trakya University School of Medicine, Edirne, Turkey
2Department of Pediatric Surgery, Trakya University School of Medicine, Edirne, Turkey

Although hepatoblastoma is rare, it is the most malignant tumour of childhood. Treatment is usually done by surgical resection and chemotherapy. The mortality and morbidity have decreased due to improvements in the treatments. In this process, hepatic resection has a risk of pulmonary embolism, and this condition could be fatal. In this case, a 9-month-old patient who was treated with chemotherapy and then underwent hepatectomy was presented. We used non-invasive methods such as the perfusion index (PI), the plethysmographic variability index (PVI) (Massimo Radical 7) and non-invasive total haemoglobin measurement (SpHb) rather than invasive measurements. During closure of the surgical skin incision, the end-tidal CO2 (ETCO2) value dropped, after which arrhythmia and bradycardia resulted in cardiac arrest. Cardiopulmonary resuscitation (CPR) was initiated. However, the patient did not respond to CPR. We concluded that heparin may be administered to reduce the risk of thrombosis in patients undergoing liver surgery.

Keywords: Heart arrest, hepatoblastoma, pulmonary embolism

Corresponding Author: Alkin Çolak, Türkiye

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