Recently, a 60-year-old patient named P.V.Đ., residing in An Giang province, complained of shortness of breath and severe fatigue; his family took him to the local hospital where he was diagnosed with pulmonary embolism with shock. To save the patient, thrombolytic therapy was required. His condition continued to evolve complexly, with shortness of breath and respiratory failure. The patient was intubated and then transferred to the University Hospital of Medicine and Pharmacy, Ho Chi Minh City.

At the University of Medicine and Pharmacy Hospital in Ho Chi Minh City, doctors recorded that Mr. D. had a massive pulmonary embolism with hemodynamic disorder and had used thrombolytic medication. Additionally, Mr. D. also had acute heart failure and hypertension. Given the urgent situation, the hospital activated the pulmonary embolism treatment team (ICU, cardiology and cardiac surgery).

After that, the patient regained consciousness, breathed calmly through the endotracheal tube, was on mechanical ventilation, the signs of respiratory failure had improved so the endotracheal tube was removed. However, Mr. D.'s condition still had many complex issues, he complained of pain in the left hip and back. At these locations, bruises appeared, progressively enlarging. The patient's pulse was rapid, difficult to catch.

The lower extremity vascular ultrasound results show that Mr. D. has a subacute thrombus completely occluding the deep femoral vein on the right. The pulmonary embolism treatment team consulted emergency cardiology, decided to discontinue anticoagulant medication and place an inferior vena cava filter for the male patient. As a result, the clot gradually reduced.

After two weeks of intense stress, the lung transplantation team at the University of Medicine and Pharmacy Hospital in Ho Chi Minh City managed to save the life of a high‑risk acute lung transplant case with hemodynamic disorder, heart failure, E. coli pneumonia, venous thrombus in the abdominal cavity – lower limbs, idiopathic hypertension, gastroesophageal reflux… When they arrived at the hospital, everyone thought this case could range from mild to severe, but Mr. D. recovered and was discharged home.

Ph.D. - Dr. Bùi Thế Dũng, Head of the Cardiology Department, University Medical and Pharmacy Hospital of Ho Chi Minh City, examined a patient with pulmonary embolism

The mortality rate and complications have sharply decreased 

According to Dr. Bùi Thế Dũng - Head of Cardiology Department, University of Medicine and Pharmacy Hospital Ho Chi Minh City,The case of patient D. is a typical clinical case that demonstrates the importance of a coordinated team approach in the diagnosis and management of pulmonary embolism.

Pulmonary embolism carries a very high risk of death. In developed countries, multidisciplinary treatment protocols for patients with pulmonary embolism have been applied for a long time, but in Vietnam they have not yet been implemented. Ho Chi Minh City University of Medicine and Pharmacy Hospital is the first unit to implement this protocol.

Research data on patients with pulmonary embolism over the past 1.5 years have shown encouraging results. The mortality rate of pulmonary embolism patients who have been hospitalized since the activation of this multidisciplinary process has significantly decreased, patients also experience fewer complications, and many cases receive timely high‑tech medical interventions.

After the hospital implemented an interdisciplinary treatment protocol for patients with pulmonary fibrosis, statistical data on 77 patients showed that the mortality rate decreased to 9.1%; 16.5% received high-tech medical interventions, and the rate of hemorrhagic complications dropped to only 14.3%.

In reality, the number of patients with pulmonary embolism admitted to Ho Chi Minh City University of Medicine and Pharmacy Hospital has been increasing. In 2018, the hospital recorded 43 cases, whereas now on average the hospital treats about 100 pulmonary embolism cases per year. Because of the benefits it brings to patients, Dr. Bùi Thế Dũng hopes that the multidisciplinary treatment process for patients with pulmonary embolism will not only be applied at the University of Medicine and Pharmacy Ho Chi Minh City which will be widely deployed in other facilities that meet the necessary medical conditions.

Source: Women's Newspaper