title: Out-of-hospital thrombolytic therapy during cardiopulmonary resuscitation in refractory cardiac arrest due to acute myocardial infarction.
abstract: Out-of-hospital thrombolytic therapy was administrated to a 53-year-old woman with confirmed acute myocardial infarction and refractory cardiac arrest. Standard advanced cardiac life support measures were performed by an out-of-hospital critical care team but they were unsuccessful. Thrombolytic therapy was given as a rescue therapy after prolonged cardiopulmonary resuscitation. The patient recovered a sinus rhythm and circulation 20 minutes after a bolus infusion of tissue plasminogen activator and was fit to be transported to the hospital. Reversal of arterial occlusion was confirmed at the hospital. There was no sequelae related to thrombolytic therapy and the patient was finally discharged 21 days later. This is the first published report of out-of-hospital thrombolytic therapy during cardiopulmonary resuscitation for a patient with refractory cardiac arrest due to acute myocardial infarction.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Beaujon University Hospital, Clichy, France.
authors.forename: F X
authors.initials: FX
authors.lastname: Duchateau
authors.forename: V
authors.initials: V
authors.lastname: Preiss
authors.forename: A
authors.initials: A
authors.lastname: Ricard-Hibon
authors.forename: C
authors.initials: C
authors.lastname: Chollet
authors.forename: J
authors.initials: J
authors.lastname: Marty
mesh_terms: D000553:Ambulatory Care; D016887:Cardiopulmonary Resuscitation; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007275:Injections, Intravenous; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy*; D010960:Plasminogen Activators / Q000627:therapeutic use; D015912:Thrombolytic Therapy; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator