Int J Surg Case Rep 2022 Jun 11;95:107181. Epub 2022 May 11.
Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China. Electronic address:
Introduction And Importance: Postoperative complication of thoracic surgery often consists of bleeding, pneumothorax, pulmonary atelectasis, infection, etc.; however, concomitant diseases such as thyroid hormone disorder deserve to think about and summarized.
Case Presentation: This case was reported as a rare postoperative cardiopulmonary arrested of a 46-year-woman who presented bilateral lung nodules with concomitant subtotal thyroidectomy 2 months ago with Toremifene Citrate to sustain thyroid hormones. 3D-VATS was allowed to be conducted after her preoperative examination and blood tests. Unexpectedly, she suddenly fell in the bathroom at 5 pm the next day. Thirty minutes later, while finding cardiopulmonary arrest CPR endotracheal intubation assisted ventilation; in the meantime, that conducted vasoactive interventions for 50 min. Finally, the patient's heart rhythm recovered, and her vital sign index slowly tended to normal.
Clinical Discussion: Cardiopulmonary arrested usually occurs in massive invasive surgery, sudden severe diseases such as stroke, myocardial infarction, or pulmonary embolism. Even if certain chronic physical diseases are related, clinical symptoms usually catch the surgeon's attention. Ultimately, the excluded major inducing reasons during the medical process in ICU; by contract, it is still to discuss the thyroid hormones disorder that could not convince us to explain this postoperative cardiopulmonary arrest.
Conclusion: Although this cardiopulmonary resuscitation for more than 30 min and following medical treatment in ICU was undoubtedly successful, it is necessary to focus on managing concomitant thyroid hormones during surgery and think about certain physiological changes if it was one of the reasons.