[Bolus injection of recombinant tissue-type plasminogen activator during cardiopulmonary resuscitation in massive pulmonary embolism complicated with heart arrest. Report of 2 cases and review of the literature].
In the early phase of fulminant pulmonary embolism mortality is extremely high, with 50% of all deaths occurring within 2 hours after the onset of symptoms. We describe 2 cases of massive pulmonary embolism accompanied by cardiac arrest requiring cardiopulmonary resuscitation. The patients received 100 mg of recombinant tissue-type plasminogen activator in bolus injection and showed a definite improvement in the clinical-hemodynamic status. In our opinion, bolus lysis made a definitive contribution to the success of resuscitation. Several other case reports and small series showed successful treatment of pulmonary embolism during similar circumstances using high-dose bolus injection of thrombolytic agents. We conclude that bolus administration of thrombolytic agents during cardiopulmonary resuscitation for massive pulmonary embolism may be an acceptable and successful technique, available also in community hospitals.
Moretti
Claudio
C
U.O. A.D.U. di Cardiologia, A.S.O. San Giovanni Battista Molinette, Torino. drclamore@yahoo.it
De Felice
Francesco
F
Mazza
Antonio
A
Pinneri
Francesco
F
D000368:Aged; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006323:Heart Arrest / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007267:Injections; D011655:Pulmonary Embolism / Q000150:complications / Q000188:drug therapy*; D011994:Recombinant Proteins / Q000008:administration & dosage; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*
D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator