ReviewThe Permanente journal2018
Refractory Hypoxemia in a Patient with Submassive Pulmonary Embolism and an Intracardiac Shunt: A Case Report and Review of the Literature.
Review in The Permanente journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
10 citing papers in PubMed, 13 citations in OpenAlex.
- Refractory Hypoxemia as a Trigger for Systemic Thrombolysis in Intermediate-High-Risk Pulmonary Embolism: A Case Report.Reports (MDPI) · 2025Article
- Patent Foramen Ovale Closure With Catheter-Directed Thrombolysis in Acute Pulmonary Embolism.Cureus · 2025Article
- Severe neurological decompression sickness associated with right ventricular dilatation and a persistent foramen ovale.Diving and hyperbaric medicine · 2025Article
- CT imaging determinants of persistent hypoxemia in acute intermediate-risk pulmonary embolism.Journal of thrombosis and thrombolysis · 2023Article
- Outcomes of Surgical and Mechanical Thrombectomy in Massive Saddle Pulmonary Embolism: A National Perspective.Cureus · 2022Article
- Evidence-based perioperative diagnosis and management of pulmonary embolism: A systematic review.Annals of medicine and surgery (2012) · 2022Review
- Percutaneous stent implantation for occluded central shunts in adults: A case report and review of current evidence.Frontiers in cardiovascular medicine · 2022Review
- Stroke and refractory hypoxaemia: complications of pulmonary embolism.BMJ case reports · 2021Article
- An unusual case of persisting hypoxia in a patient with a thrombolysed pulmonary embolism.Clinical medicine (London, England) · 2020Article
- Hypoxemia in COVID-19 patients: An hypothesis.Medical hypotheses · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAcute pulmonary embolism is the third leading cause of cardiovascular death. Management options include anticoagulation with or without thrombolysis. Concurrent persistent hypoxemia should be a clue to the existence of an intracardiac shunt. CASE PRESENTATION: A 46-year-old man experienced acute hypoxemic respiratory failure requiring mechanical ventilation after anesthesia induction for elective hip arthroplasty. He was found to have submassive bilateral pulmonary emboli with acute right ventricular dysfunction and a coexisting patent foramen ovale with right-to-left shunt. He remained profoundly hypoxemic despite catheter-directed thrombolysis. He underwent surgical embolectomy with partial endarterectomy, resulting in clinical improvement. DISCUSSION: The management of acute submassive pulmonary embolism is undertaken on an individualized basis because of the wide spectrum of clinical presentations. In this report we review the literature and discuss the evidence behind the management of cases of acute pulmonary embolism complicated by hypoxemia from a patent foramen ovale. In a case of acute pulmonary embolism complicated by refractory hypoxemia from an intracardiac shunt, adjunctive therapies in addition to anticoagulation and thrombolysis must be considered.
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