[Retrospective analysis of 15 cases with severe pulmonary embolism]

We evaluated retrospectively the clinical indicators for the treatment of 15 patients with severe pulmonary embolism. All patients had moderate or severe pulmonary hypertension with deteriorated oxygenation. Thrombolytic agents and catecholamines were administered and mechanical ventilation was performed so as to treat right heart failure and improve oxygenation. In 14 patients, the pulmonary artery pressure decreased gradually and PaO2 increased in response to these therapies. The 14 patients were discharged from ICU without any symptoms. One patient died of cerebral hemorrhage due to the side effects of tissue plasminogen activator. We conclude that the pulmonary artery pressure and PaO2 are useful indicators for the treatment of the early phase of severe pulmonary embolism. Moreover, timely use of cetecholamine is very important for the maintenance of pulmonary circulation and acceleration of thrombolysis.