Home|Journals|Articles by Year|Audio Abstracts

Case Report

Anaesth. pain intensive care. 2022; 26(1): 115-118

Systemic Thrombolysis and Anticoagulation in Postpartum Patient with Acute Respiratory Distress Syndrome (ARDS) COVID-19 and Acute Pulmonary Embolism (PE) in Intensive Care Unit: a Case Report

Samuel Hotma Rotua, Dwisetyo Gusti Arilaksono, Shinta Vera Hutajulu.


COVID-19 has a wide range of clinical presentations from asymptomatic cases to severe respiratory distress, multi-organ dysfunction, and death. Pulmonary embolism (PE) is the most feared and severe spectrum of venous thromboembolism (VTE). We present a case of healthy 25-year-old nonsmoking pregnant woman (gravid 2, no history of abortion/miscarriage) underwent an elective caesarean section at 39 weeks of gestation after uneventful pregnancy, whom afterwards exhibit clinical presentation of pulmonary embolism (PE) overlapping with severe COVID-19 pneumonia. The diagnosis was made based on severe oxygen desaturation, McConnel sign finding on POCUS and elevated d-dimer level (34.19 mcg/mL). Alteplase and low-molecular-weight heparin were used, immediately obtained clinical improvement. We should be warned about high or extremely elevated D-Dimer measurements and severe oxygen desaturation, as possible risk markers of severe COVID-19 pneumonia in patients with high clinical suspicion of PE. Thrombolysis could be an effective and safe therapy for PE in ARDS COVID-19 patients. Furthermore, we underline that POCUS, despite its inherent limitations, could be a flexible diagnostic and management tool in refractory ARDS due to COVID-19.

Key words: COVID-19, SARS-CoV-2, Pulmonary Embolism, Thrombolytic Therapy, Postpartum Period, Point-of-Care Ultrasound

Full-text options

Share this Article

Online Article Submission
• ejmanager.com

ejPort - eJManager.com
Review(er)s Central
About BiblioMed
License Information
Terms & Conditions
Privacy Policy
Contact Us

The articles in Bibliomed are open access articles licensed under Creative Commons Attribution 4.0 International License (CC BY), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.