Thrombolysis During Resuscitation for Out-of-Hospital Cardiac Arrest Caused by Pulmonary Embolism Increases 30-Day Survival: Findings From the French National Cardiac Arrest Registry.

Chest
François JavaudinResearch Group of the French National Out-of-Hospital Cardiac Arrest Registry (GR-RéAC)

Abstract

Pulmonary embolism (PE) represents 2% to 5% of all causes of out-of-hospital cardiac arrest (OHCA) and is associated with extremely unfavorable prognosis. In PE-related OHCA, inconsistent data showed that thrombolysis during cardiopulmonary resuscitation may favor survival. This was a retrospective, observational, multicenter study from July 2011 to March 2018. All adults with OHCA, treated by a mobile ICU and with a diagnosis of PE confirmed on hospital admission, were included. The primary end point was 30-day survival in a weighted population. Of the 14,253 patients admitted to hospitals, 328 had a final diagnosis of PE and 246 were included in the analysis. In the group that received thrombolysis during resuscitation (n = 58), 14 (24%) received alteplase, 43 (74%) received tenecteplase, and one (2%) received streptokinase. Thirty-day survival was higher in the thrombolysis group than in the control group (16% vs 6%; P = .005; adjusted log-rank test) but the good neurologic outcome was not significantly different (10% vs 5%; adjusted relative risk, 1.97; 95% CI, 0.70-5.56). Median duration of stay in the ICU was 1 (0-5) day for the thrombolysis group and 1 (0-3) day for the control group (P = .23). In patients with OHCA with...Continue Reading

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Citations

Dec 15, 2019·Critical Care : the Official Journal of the Critical Care Forum·François JavaudinUNKNOWN GR-RéAC
Jul 13, 2020·Resuscitation·Abhishek DuttaWaqas T Qureshi
Mar 29, 2021·Resuscitation·Jasmeet SoarJerry P Nolan
Mar 29, 2021·Resuscitation·Carsten LottUNKNOWN ERC Special Circumstances Writing Group Collaborators
May 11, 2021·Thrombosis Research·M J BakkumP R Tuinman
May 27, 2021·Clinical and Experimental Emergency Medicine·Jaehoon OhUNKNOWN Steering Committee of the 2020 Korean Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
May 27, 2021·Clinical and Experimental Emergency Medicine·Young-Min KimUNKNOWN Steering Committee of 2020 Korean Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Jun 16, 2021·Notfall & Rettungsmedizin·Carsten LottJasmeet Soar
Jun 15, 2021·Notfall & Rettungsmedizin·Jasmeet SoarJerry P Nolan
Aug 30, 2021·Lancet·Jasmeet SoarMichael J A Parr

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