Thrombolytic therapy of massive pulmonary embolism during prolonged cardiac arrest using recombinant tissue-type plasminogen activator

Annals of Emergency Medicine
R W LangdonD A Schwartz

Abstract

Cardiac arrest caused by massive pulmonary embolism is highly refractory to conventional resuscitation. Emergency surgical embolectomy has been considered the only effective intervention. We present the case of a 33-year-old woman who suffered a massive pulmonary embolism with circulatory arrest refractory to one half hour of aggressive CPR. A 10-mg bolus of recombinant tissue-type plasminogen activator was administered through a central line followed by a further 90-mg IV infusion over two hours. Rapid hemodynamic and clinical improvement followed the bolus dose. The patient was discharged later without neurological or other sequelae. This is the first reported case of successful thrombolytic therapy of massive pulmonary embolism during prolonged CPR.

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Citations

Feb 24, 1998·The Journal of Emergency Medicine·R R RudoniA M Hauser
May 17, 2002·The New England Journal of Medicine·Riyad B Abu-LabanVictor M Wood
Nov 9, 2001·Critical Care Medicine·M R BailénE Aguayo De Hoyos
Mar 10, 2005·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Gianfranco de RoseAngelo Fanciulli
Feb 18, 2016·Critical Care Research and Practice·Houssein YounessJean Keddissi
Jul 29, 2008·Emergency Medicine Clinics of North America·J Matthew Fields, Munish Goyal
Jan 20, 2005·The Journal of Emergency Medicine·David H Newman, Ian B Greenwald
May 1, 1992·The Journal of Emergency Medicine·M J Rieser
Apr 12, 2003·Clinics in Chest Medicine·Selim M Arcasoy, Anil Vachani
Dec 2, 2010·The Annals of Pharmacotherapy·Jerrold PerrottPeter J Zed
Apr 12, 2003·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Fabian Spöhr, Bernd W Böttiger

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