Low-dose tenecteplase during cardiopulmonary resuscitation due to massive pulmonary embolism: a case report and review of previously reported cases.
The case of a 29 year-old man who suffered a cardiac arrest due to a massive pulmonary embolism while he was undergoing surgical repair of a complex tibial plateau fracture is presented. After 70 min of unsuccessful cardiopulmonary resuscitation a bolus of 20 mg tenecteplase was given, with a return of spontaneous circulation 2 min after administration of the drug. Pulmonary embolism was subsequently demonstrated on a pulmonary angiogram. To our knowledge this is the first report to show that the use of a low dose of tenecteplase might be useful to achieve the return of spontaneous circulation in the resuscitation of patients with cardiac arrest secondary to massive pulmonary embolism. Previously reported cases are reviewed.
Hefer
David Václav Fred
DV
Cardiovascular Research Center, University of Vermont, College of Medicine, Burlington, Vermont, USA. dhefer@uvm.edu
Munir
Aman
A
Khouli
Hassan
H
D000328:Adult; D001775:Blood Circulation / Q000187:drug effects; D016887:Cardiopulmonary Resuscitation; D017809:Fatal Outcome; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy; D006801:Humans; D007431:Intraoperative Complications / Q000188:drug therapy*; D008297:Male; D011655:Pulmonary Embolism / Q000188:drug therapy* / Q000209:etiology; D012131:Respiratory Insufficiency / Q000209:etiology; D000077785:Tenecteplase; D013978:Tibial Fractures / Q000150:complications / Q000601:surgery; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator; D000077785:Tenecteplase