Oct 3, 2003

Efficacy of alteplase thrombolysis for ED treatment of pulmonary embolism with shock

The American Journal of Emergency Medicine
Philippe Le ConteDenis Baron


Our objective was to assess efficacy and tolerance of thrombolysis using 0.6 mg/kg of Alteplase in patients with massive pulmonary embolism defined as the association of a pulmonary embolism with shock. We retrospectively included 21 patients presenting with a massive pulmonary embolism confirmed by either scintigraphy or spiral computed tomography. Patients were treated on the basis of a standard rationale followed by thrombolysis with 0.6 mg/kg Alteplase over a period of 15 minutes. Hospital mortality, vital signs before and 2 hours after thrombolysis, and incidence of hemorrhagic events were recorded. Five patients (23.8%) died, 4 of these deaths occurred during the first 4 hours after hospital admission. Systolic and diastolic blood pressure (Sp02) were significantly improved 2 hours after the beginning of thrombolysis. Five minor hemorrhagic events occurred. This study demonstrates that for patients with pulmonary embolism and shock, a bolus treatment with Alteplase is potentially effective and well tolerated.

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Mentioned in this Paper

Diastolic Blood Pressure Measurement
Pulmonary Embolism
Antithrombotic Agents
Thrombolytic Therapy
Retrospective Studies
Accident and Emergency Department
Hypovolemic Shock
Tomography, Spiral Computed

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