Case Report

Pulmonary Embolism During Hepatoblastoma Resection

10.5152/TJAR.2019.45336

  • Alkin Çolak
  • Ümit Nusret Başaran
  • Elif Çopuroğlu
  • Fatih Sağ
  • Zafer Çakıcı
  • Güven Kıray

Received Date: 14.02.2019 Accepted Date: 27.03.2019 Turk J Anaesthesiol Reanim 2020;48(1):79-81

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