Abstract:

Massive pulmonary embolism is a vital emergency pulmonary pathology. Early diagnosis and treatment approach reduce mortality. Thrombolytic applications play an important role in the treatment. However, complications of thrombolytic therapy put a serious strain on physicians. In this case series, we aimed to present the management of carbon dioxide retention with the EzPAP® device in two young massive embolism patients who were given thrombolytic therapy. Our 26 and 36-year-old male patients applied to our emergency department with complaints of flank pain and syncope, respectively. Massive PTE was detected in PCTAs taken due to hypoxia and tachycardia in our patients. When carbon dioxide retention developed in patients who were decided to be given thrombolytic therapy, barotrauma, which could be caused by non-invasive mechanical ventilation, was withdrawn. And it was decided to apply EzPAP® to these patients. In both patients, hypoxia and carbon dioxide retention were treated in a short time without complications. Etiological investigations of the patients are continuing and they were discharged with convalescence. Conclusion; While thrombolytic therapy provides rapid and positive results, it also includes serious life-threatening side effects such as bleeding. EzPAP® can be used as an alternative treatment method for thrombolytic-related bleeding that may develop in the face and respiratory tract due to barotrauma of non-invasive mechanical ventilation.

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