13 April 2026
: Case report 
Heparin and Venoarterial Extracorporeal Membrane Oxygenation in Massive Pulmonary Embolism Management: A Case Report
Unknown etiology, Mistake in diagnosis, Unusual or unexpected effect of treatment
Dongmei Yang ABCDE 1, Yujun Zhang BC 1, Guohua Liu AC 1*, Yixuan Zhao B 1, Min Hao F 1DOI: 10.12659/AJCR.951235
Am J Case Rep 2026; 27:e951235
Table 1 Dynamic laboratory parameters throughout hospitalization.
| Laboratory test | Timeline of events | ||||||
|---|---|---|---|---|---|---|---|
| Transferred to ICU | Deterioration (11 h later) | 4 hours post-thrombolysis | 4 hours post-ECMO | 24 hours post-VA-ECMO | Day 5 | Day 8 | |
| pH | 7.372 | 7.179 | 7.038 | 7.359 | 7.421 | 7.352 | 7.36 |
| Partial pressure of oxygen (PO2) (mmHg) | 74 | 83 | 99 | 65 | 107 | 70 | 103 |
| Lactate (Lac) level (mmol/L) | 3.13 | 14.3 | 18.12 | 15.49 | 2.4 | 2.12 | 1.92 |
| Activated partial thromboplastin time (APTT) (s) | 29 | 72.9 | 98.8 | 64.6 | 53.8 | 57.5 | 50 |
| International normalized ratio (INR) | 1.25 | 1.72 | 1.78 | 2.1 | 1.62 | 1.26 | 0.89 |
| D-dimer level (ug/ml) | 15.85 | 18.66 | >80 | 78.61 | 72.29 | 69.9 | 12.89 |
| Platelet count (10/L) | 153 | 81 | 93 | 77 | 84 | 72 | 55 |
| N-terminal probrain natriuretic peptide (NT-proBNP) level (pg/ml) | 162.9 | 8582 | 13658 | 10364 | 2871 | 1634 | 355.1 |
| Troponin level (ug/L) | 0.215 | 0.582 | 0.954 | 0.194 | 0.083 | 0.042 | |
| Alanine transaminase (ALT) level (U/L) | 65 | 716 | 5800 | 3547 | 2418 | 498 | |
| Aspartate aminotransferase (AST) level (/U/L) | 60 | 644 | 10900 | 3620 | 1382 | 157 | |
| Creatinine (Cr) level (μmol/L) | 96 | 220 | 269 | 339 | 195 | 165 | 102 |
| ICU – intensive care unit; VA-ECMO – venoarterial extracorporeal membrane oxygenation. | |||||||