Abstract
Objective: To describe three acutely decompensated diabetic patients who suffered massive pulmonary embolism within 72 hours of admission.
Design: Case series and literature review.
Setting: University-affiliated urban hospital center.
Patients: Three patients with severe hyperglycemia and ketoacidosis or hyperosmolar state who developed massive pulmonary embolism.
Interventions: Intravenous heparin, recombinant tissue plasminogen activator, advanced cardiac life support.
Results: Massive pulmonary embolism proved rapidly fatal in the two cases that manifested as pulseless electrical activity cardiac arrest.
Conclusions: Critical care clinicians must recognize the potential for massive, life-threatening pulmonary embolization in patients with decompensated diabetes.